Men who have sex with men (MSM) who are living with HIV and contract hepatitis C virus (HCV) are at risk of rapid progression of liver fibrosis (scarring), aidsmap reports. Multiple U.S. and European studies have reached this conclusion, and now a larger study on the topic has come out of Germany.

There is an epidemic of sexually transmitted HCV among HIV-positive MSM in particular. HIV-negative MSM are also at risk but apparently to a lesser extent.

The German researchers conducted a retrospective single-center cohort study spanning 2002 to 2013 and including 178 HIV-positive MSM who contracted HCV 213 times. Eighteen percent of these infections were reinfections after a man had spontaneously cleared or been cured of hep C.

A total of 10.8 percent of the men spontaneously cleared hep C without any treatment for that virus, a phenomenon that was associated with older age, lower HCV viral load and higher ALT liver enzyme levels during the acute phase after infection.

Clinicians treated 86.3 percent of the men for hep C (all were treated with interferon), of whom 70.7 percent achieved a sustained virologic response 12 weeks after completing therapy (SVR12, considered a cure). 

After a median 38.7 months of follow-up, 39.4 percent of the men developed moderate fibrosis or higher, meaning at least a Metavir F2 stage (there are four stages, the last of which is cirrhosis). In the grand scope of hep C disease progression, this is considered particularly swift. Factors associated with a higher fibrosis stage included older age, being an alcoholic according to a physician’s declaration and not responding to hep C treatment during the acute phase of infection.

The researchers stressed that close liver monitoring is vital for this population, especially if there is a delay in hep C treatment.

To read the aidsmap article, click here.

To read the study abstract, click here.