In a newly published paper in The Lancet Gastroenterology & Hepatology, WHO, in collaboration with the Kirby Institue of UNSW Sydney, Australia, provided a meta-analysis of the prevalence and incidence of hepatitis C virus (HCV) infection in men who have sex with men. This year’s Nobel Prize in Physiology or Medicine went to Michael Houghton, Harvey Alter and Charles Rice for their discovery of HCV which they called a global threat to human health. 71 million people have chronic HCV infection globally with 1.75 million new infections each year.
In the meta-analysis, 194 eligible publications were assessed. Even though substantial variations across countries were recorded, the overall prevalence of HCV amongst men who have sex with men was 3.4% (95% CI: 2.8-4.0). There was also a finding that confirmed a higher risk of HCV infection in HIV positive men who have sex with other men with a 6.3% (95% CI: 5.3-7.5) prevalence of HCV infection in HIV positive men compared to 1.5% (95% CI: 1.0-2.1) prevalence in HIV negative men.
The major contributor to HCV transmission is injecting drug use. Amongst the study population with HCV infection in the meta-analysis, 30.2% (95% CI: 22.0-39.0) had ever injected and 45.6% 95% (CI: 21.6 – 70.7) currently inject drugs compared to 2.7% (95% CI: 2.0-3.6) who had never injected drugs. Dr Niklas Luhmann from WHO emphasized how critical it is to reach and support men who have sex with men who also inject drugs with effective prevention, testing and treatment services.
Lastly, another major finding of this paper was the higher incidence of HCV among men taking PrEP. This was attributed to multiple factors. Men who choose to use PrEP usually are at higher risk for HIV, have barriers to condom use and/or greater sexual interaction with HIV positive men. However, a high prevalence of HCV in HIV negative men who chose PrEP was observed before PrEP initiation. This is all a call for improved access to prevention, testing and treatment for high risk, populations including marginalized populations.
-Bethel
Reference
https://www.nobelprize.org/prizes/medicine/2020/press-release/
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