A study of gay and bisexual men diagnosed with recently acquired hepatitis C infection and treated in three English clinics has found that 40% of them were HIV negative, the 25th Annual Conference of the British HIV Association (BHIVA) was told in Bournemouth this week, though all the HIV-negative men were in London.
Daniel Bradshaw of Public Health England said the HIV-negative men were on average younger and had a higher average number of sex partners than HIV-positive men with hepatitis C; 81% were using pre-exposure prophylaxis (PrEP) or had done in the last year.
This study adds to recent evidence from France and the Netherlands that PrEP may be associated with changes in sexual risk behaviour and the epidemiology of sexually transmitted infections. Historically, hepatitis C that is sexually transmitted – or rather, associated with sex, as sharing of drug injection equipment during ‘chemsex’ may also transmit infection – has been almost exclusively seen in HIV-positive gay men. So much so, that it was hypothesised that only HIV-positive people were susceptible to hepatitis C infection. An international review showed that the annual incidence of hepatitis C in HIV-positive men rose fivefold from 0.32% in 1990 to 1.6% in 2015; in contrast, it rose non-significantly from 0.04% to 0.08% in HIV-negative men over the same period.
More recently, studies from Lyon in France and Amsterdam in the Netherlands have found that a much higher proportion of gay men acquiring hepatitis C are now HIV negative.