Explosion of Sex-Spread Hepatitis C in HIV-Positive Men

[Shaytan]

July 21, 2011 -- There is an ongoing "explosion" of deadly hepatitis C among men who have sex with men.

It's spread mainly by anal sex, often enhanced by methamphetamine, according to a report in the July 21 issue of the CDC's Morbidity and Mortality Weekly Report.

"We are having an explosion of sexually transmitted hepatitis C," study researcher Daniel S. Fierer, MD, of New York's Mount Sinai School of Medicine, tells WebMD. "We have uncovered an emerging epidemic of sexual transmission of hepatitis C. And the main reason is men having anal sex without a condom."

It's no surprise to experts who treat hepatitis C. Liver cancer and cirrhosis caused by hepatitis C virus (HCV) already is the leading cause of death among people with HIV infection who have access to HIV drugs. Some 30% of Americans with HIV are co-infected with HCV.

Sexual transmission of HCV among people without HIV is rare, notes Eugene R. Schiff, MD, director of the Center for Liver Diseases at the University of Miami, who was not involved in the Fierer/CDC study. Among heterosexual couples, he says, only 2% of those with HCV infect their partners after 20 years of monogamous marriage.

The same may be true for men who have sex with men -- if they practice safe sex.

"Our data do not support sexual HCV transmission between HIV-negative men," Fierer says. "There is reasonable data that HIV-negative men are not part of this epidemic."

But that's not the case for HIV-positive men, notes Lynn E. Taylor, MD, of Brown University. Taylor was not involved in the Fierer study. In a study published last March, Taylor and her colleagues showed that new HCV infections are relatively common among HIV-positive men who do not use intravenous drugs -- a phenomenon previously reported in Europe and Australia.

"We have robust evidence of increasing HCV incidence among men who have sex with men who do not inject drugs but do engage in high-risk sexual behaviors," Taylor, who was not involved in the Fierer study, tells WebMD. "It is the new sexually transmitted infection in this population. I am very concerned."

Schiff notes that when HIV-positive men get HCV, they have much higher levels of the hepatitis C virus in their blood. Taylor and Schiff warn that hepatitis C infection progresses quickly in people with HIV infection.

"These men are sitting ducks for liver cancer," Taylor says. "If they don't get treated and get HCV eradication, they are at risk of cirrhosis or liver cancer. ... We are seeing tons of gay men newly diagnosed with HIV, and then with HCV. I could go to a funeral of an HCV patient every week."

[bbbslut7]

Can you be vaccinated for Hep C?

[rawTOP]

Can you be vaccinated for Hep C?

No, just Hep A & B. Treatments don't always work for Hep C and the people who can't get rid of it say it's worse than having HIV.

[Hotload84]

Two of my neighbors have (or have had) Hep C, and they both tell me they were successfully treated for the virus. Apparently there are various genotypes for the virus, and each genotype has a different treatment outcome. Here is an extract from Wikipedia:

Cure rates by genotype. Responses can vary by genotype. Approximately 80% of hepatitis C patients in the United States have genotype 1, and genotype 4 is more common in the Middle East and Africa.

Genotype / Description

Genotypes 2 and 3

Sustained cure rates (sustained viral response) of 75% or better are seen in people with HCV genotypes 2 and 3 with 24 weeks of treatment.[43] Patients achieving HCV RNA below 1000 IU/mL by day 7 (i.e. just prior to the second dose of pegylated interferon) may be treated for as little as 12 weeks with retained sustained cure rates.[37]

Genotype 1

Sustained response is about 50% in patients with HCV genotype 1 given 48 weeks of treatment. In patients with HCV genotype 1, if treatment with pegylated interferon + ribavirin does not produce a 2-log viral load reduction or complete clearance of RNA (termed "early virological response") after 12 weeks the chance of treatment success is less than 1%.

Genotype 4

Sustained response is about 65% in those with genotype 4 given 48 weeks of treatment.

Genotype 5

HCV genotype 5, which is seen most often in parts of Africa, and genotype 6, which predominates in Southeast Asia, are rare in the U.S. and Europe, and their treatment has not been as extensively studied. Genotypes 5 and 6 respond better to interferon-based therapy than genotype 1, but do not appear as easy to treat as genotypes 2 or 3, according to 2 studies presented at the recent Disease Week annual meeting (DDW 2009) in Chicago. http://www.hivandhepatitis.com/2009icr/ddw/docs/061909_a.html

Genotype 6

The evidence for treatment in genotype 6 disease is currently sparse, and the evidence that exists is for 48 weeks of treatment at the same doses as are used for genotype 1 disease.[44] Physicians considering shorter durations of treatment (e.g., 24 weeks) should do so within the context of a clinical trial.

Edited October 23, 2011 by Hotload84

[tboyer]

Everyone is of course different, but I'm HIV+, and have had a number of guys who were HIV+ and HEP-C + breed my ass, and those were the ones I knew about, I'm certain others have bred my ass without me knowing. I'm still HEP-C negative The guys breeding my ass, got off on trying to convert me to HEP-C +

July 21, 2011 -- There is an ongoing "explosion" of deadly hepatitis C among men who have sex with men.

It's spread mainly by anal sex, often enhanced by methamphetamine, according to a report in the July 21 issue of the CDC's Morbidity and Mortality Weekly Report.

"We are having an explosion of sexually transmitted hepatitis C," study researcher Daniel S. Fierer, MD, of New York's Mount Sinai School of Medicine, tells WebMD. "We have uncovered an emerging epidemic of sexual transmission of hepatitis C. And the main reason is men having anal sex without a condom."

It's no surprise to experts who treat hepatitis C. Liver cancer and cirrhosis caused by hepatitis C virus (HCV) already is the leading cause of death among people with HIV infection who have access to HIV drugs. Some 30% of Americans with HIV are co-infected with HCV.

Sexual transmission of HCV among people without HIV is rare, notes Eugene R. Schiff, MD, director of the Center for Liver Diseases at the University of Miami, who was not involved in the Fierer/CDC study. Among heterosexual couples, he says, only 2% of those with HCV infect their partners after 20 years of monogamous marriage.

The same may be true for men who have sex with men -- if they practice safe sex.

"Our data do not support sexual HCV transmission between HIV-negative men," Fierer says. "There is reasonable data that HIV-negative men are not part of this epidemic."

But that's not the case for HIV-positive men, notes Lynn E. Taylor, MD, of Brown University. Taylor was not involved in the Fierer study. In a study published last March, Taylor and her colleagues showed that new HCV infections are relatively common among HIV-positive men who do not use intravenous drugs -- a phenomenon previously reported in Europe and Australia.

"We have robust evidence of increasing HCV incidence among men who have sex with men who do not inject drugs but do engage in high-risk sexual behaviors," Taylor, who was not involved in the Fierer study, tells WebMD. "It is the new sexually transmitted infection in this population. I am very concerned."

Schiff notes that when HIV-positive men get HCV, they have much higher levels of the hepatitis C virus in their blood. Taylor and Schiff warn that hepatitis C infection progresses quickly in people with HIV infection.

"These men are sitting ducks for liver cancer," Taylor says. "If they don't get treated and get HCV eradication, they are at risk of cirrhosis or liver cancer. ... We are seeing tons of gay men newly diagnosed with HIV, and then with HCV. I could go to a funeral of an HCV patient every week."

Edited October 18, 2011 by Hotload84

[PhoenixGeoff]

I'd mostly associated the spread of Hep-C with sharing of syringes while using IV drugs and such. Considering the rather large overlap between people who bareback and people who use T and other drugs, it may be hard to control for that in a study.

Then there's also the consideration that Hep-C can survive rather longer outside of the body than HIV can. So it can be passed if you happen to share a razor or toothbrush or even a nail clipper with someone who has it. Which may account for how it sometimes gets spread between partners or roommates.

Which is not to say that it can't be spread sexually. But if it can, one might ask why we're seeing it spread now, as opposed to five or ten or fifteen years ago. Is it because barebacking's more popular? Does it have something to do with HIV? Or is it something else?

[Hotload84]

...one might ask why we're seeing it spread now, as opposed to five or ten or fifteen years ago. Is it because barebacking's more popular? Does it have something to do with HIV? Or is it something else?

Good question, MascMountainMan. If I don't see a posting here I'll ask my doctor on 11/1.

[totalasspig]

With the spread of HepC, more important that us a gay sexually active men be checked for STD's every ninety days.

[CristianKnox]

Thought I'd add my (non professional) thoughts on this. I know two people who caught Hep-C, and BOTH are still HIV NEGATIVE !! BOTH however, caught it by being barebacked in group situations. As neither did/do drugs, it seems obvious that they had recieved blood into their ass from another bottom via a top. It makes sense I suppose as if a top is going from bottom to bottom he is likely spreading all sorts around. So I don't know why it has drastically risen just recently, but I expect it has something to do with an increase in barebacking, but also barebacking in group situations perhaps??