High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis

High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis

HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM). We evaluated HCV incidence and its risk factors among HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP). Participants of the Amsterdam PrEP project were tested for HCV antibodies or...

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Veröffentlicht in:Journal of hepatology 2020-05, Vol.72 (5), p.855-864
Hauptverfasser: Hoornenborg, Elske, Coyer, Liza, Boyd, Anders, Achterbergh, Roel Christiaan Alfons, Schim van der Loeff, Maarten Franciscus, Bruisten, Sylvia, de Vries, Henry John Christiaan, Koopsen, Jelle, van de Laar, Thijs J.W., Prins, Maria, de Bree, G.J., Brokx, P., Heidenrijk, M., Prins, M., Reiss, P., van der Valk, M., Davidovich, U., Geerlings, S.E., Hoornenborg, E., Oomen, A., Sighem, A. van, Zuilhof, W., Bruinderink, M.L. Groot, Achterbergh, R.C.A., Ananworanich, J., Van de Beek, D., van den Berk, G.E.L., Bezemer, D., van Bijnen, A., Blok, W.L., Bomers, M., Boucher, C.A.B., Brokking, W., Burger, D., Brinkman, K., de Bruin, M., Bruisten, S., Coyer, L., van Crevel, R., Daans, C.G., Dellemann, L., Dijkstra, M., van Duijnhoven, Y.T., van Eeden, A., Elsenburg, L., van den Elshout, M.A.M., Ester, C., Ersan, E., Felipa, P.E.V., Frissen, P.H.J., Geijtenbeek, T.B.H., Godfried, M.H., van Gool, J., Goorhuis, A., Groot, M., Heijnen, A., Hillebregt, M.M.J., Hogewoning, A., Hommenga, M., Hovius, J.W., Janssen, Y., de Jong, K., Jongen, V., Kootstra, N.A., Koup, R.A., Kroon, F.P., van de Laar, T.J.W., van Leeuwen, M.M., Lettinga, K., Linde, I., Loomans, D.S.E., Mouhebati, T., Mulder, B.J., Mulder, J., Nellen, F.J., Nijsters, A., Nobel, H., Oostvogel, P., Op de Coul, E.L.M., Peters, E., van der Poll, T., Ratmann, O., van Rooijen, M.S., Schim van der Loeff, M.F., Schoute, W.E.M., Sonder, G.J., Veenstra, J., Verdult, F., de Vocht, J., de Vries, H.J., Vrouenraets, S., van Vugt, M., Wiersinga, W.J., Wit, F.W., Woittiez, L.R., Zaheri, S., van Zelm, M.C., Żakowicz, A., Zimmermann, H.M.L.
Format: Artikel
Sprache:eng
Schlagworte:
Anal sex
Bayesian analysis
Condoms
Disease transmission
Hepatitis
Hepatitis C
Hepatitis C virus
HIV
Homosexuality
Human immunodeficiency virus
Infections
Male
Men who have sex with men
Molecular epidemiology
Phylogeny
Pre-exposure prophylaxis
Prophylaxis
Ribonucleic acid
Risk factors
Risk groups
RNA
RNA-directed RNA polymerase
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container_end_page 864
container_issue 5
container_start_page 855
container_title Journal of hepatology
container_volume 72
creator Hoornenborg, Elske
Coyer, Liza
Boyd, Anders
Achterbergh, Roel Christiaan Alfons
Schim van der Loeff, Maarten Franciscus
Bruisten, Sylvia
de Vries, Henry John Christiaan
Koopsen, Jelle
van de Laar, Thijs J.W.
Prins, Maria
de Bree, G.J.
Brokx, P.
Heidenrijk, M.
Prins, M.
Reiss, P.
van der Valk, M.
de Bree, G.J.
Davidovich, U.
Geerlings, S.E.
Hoornenborg, E.
Oomen, A.
Sighem, A. van
Zuilhof, W.
Bruinderink, M.L. Groot
Achterbergh, R.C.A.
Ananworanich, J.
Van de Beek, D.
van den Berk, G.E.L.
Bezemer, D.
van Bijnen, A.
Blok, W.L.
Bomers, M.
Boucher, C.A.B.
Brokking, W.
Burger, D.
Brinkman, K.
de Bruin, M.
Bruisten, S.
Coyer, L.
van Crevel, R.
Daans, C.G.
Dellemann, L.
Dijkstra, M.
van Duijnhoven, Y.T.
van Eeden, A.
Elsenburg, L.
van den Elshout, M.A.M.
Ester, C.
Ersan, E.
Felipa, P.E.V.
Frissen, P.H.J.
Geijtenbeek, T.B.H.
Godfried, M.H.
van Gool, J.
Goorhuis, A.
Groot, M.
Heijnen, A.
Hillebregt, M.M.J.
Hogewoning, A.
Hommenga, M.
Hovius, J.W.
Janssen, Y.
de Jong, K.
Jongen, V.
Kootstra, N.A.
Koup, R.A.
Kroon, F.P.
van de Laar, T.J.W.
van Leeuwen, M.M.
Lettinga, K.
Linde, I.
Loomans, D.S.E.
Mouhebati, T.
Mulder, B.J.
Mulder, J.
Nellen, F.J.
Nijsters, A.
Nobel, H.
Oostvogel, P.
Op de Coul, E.L.M.
Peters, E.
van der Poll, T.
Ratmann, O.
van Rooijen, M.S.
Schim van der Loeff, M.F.
Schoute, W.E.M.
Sonder, G.J.
Veenstra, J.
Verdult, F.
de Vocht, J.
de Vries, H.J.
Vrouenraets, S.
van Vugt, M.
Wiersinga, W.J.
Wit, F.W.
Woittiez, L.R.
Zaheri, S.
van Zelm, M.C.
Żakowicz, A.
Zimmermann, H.M.L.
description HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM). We evaluated HCV incidence and its risk factors among HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP). Participants of the Amsterdam PrEP project were tested for HCV antibodies or HCV-RNA every 6 months. Participants used daily or event-driven PrEP and could switch regimens during follow-up. We calculated incidence rates (IRs) for overall HCV infection and separately for primary and re-infection. A univariable Bayesian exponential survival model was used to identify risk factors associated with incident HCV infection. The HCV NS5B gene fragment (709 bp) was sequenced and compared to HCV isolates from HIV-positive MSM and other risk groups (n = 419) using phylogenetic analysis. Among 350 participants contributing 653.6 person-years (PYs), we detected 15 HCV infections in 14 participants (IR = 2.30/100PY). There were 8 primary infections (IR = 1.27/100PY) and 7 re-infections (IR = 27.8/100PY). IR was 2.71/100PY in daily and 1.15/100PY in event-driven PrEP users. Factors associated with incident HCV infection were higher number of receptive condomless anal sex acts with casual partners (posterior hazard ratio [HR] 1.57 per ln increase; 95% credibility interval [CrI] 1.09–2.20), anal STI (posterior HR 2.93; 95% CrI 1.24–7.13), injecting drug use (posterior HR 4.69; 95% CrI 1.61–12.09) and sharing straws when snorting drugs (posterior HR 2.62; 95% CrI 1.09–6.02). We identified robust MSM-specific HCV clusters of subtypes 1a, 4d, 2b and 3a, which included MSM with and without HIV. HIV-negative MSM using PrEP are at risk of incident HCV infection, while identified risk factors are similar to those in HIV-positive MSM. Regular HCV testing is needed, especially for those with a previous HCV infection and those reporting risk factors. We report that hepatitis C virus infections are frequently acquired among HIV-negative men who have sex with men (MSM) using pre-exposure prophylaxis to prevent HIV infection. New infections occurred more frequently in those reporting receptive anal sex without using condoms, having an anal sexually transmitted infection, injecting drugs, and sharing straws when snorting drugs. The viruses found in HIV-negative men using pre-exposure prophylaxis are genetically similar to those in HIV-positive men, but not in other hepatitis C risk groups, suggesting that (sexual) transmission is occurring between HIV-positive MSM an
doi_str_mv 10.1016/j.jhep.2019.11.022
format Article
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Groot ; Achterbergh, R.C.A. ; Ananworanich, J. ; Van de Beek, D. ; van den Berk, G.E.L. ; Bezemer, D. ; van Bijnen, A. ; Blok, W.L. ; Bomers, M. ; Boucher, C.A.B. ; Brokking, W. ; Burger, D. ; Brinkman, K. ; de Bruin, M. ; Bruisten, S. ; Coyer, L. ; van Crevel, R. ; Daans, C.G. ; Dellemann, L. ; Dijkstra, M. ; van Duijnhoven, Y.T. ; van Eeden, A. ; Elsenburg, L. ; van den Elshout, M.A.M. ; Ester, C. ; Ersan, E. ; Felipa, P.E.V. ; Frissen, P.H.J. ; Geijtenbeek, T.B.H. ; Godfried, M.H. ; van Gool, J. ; Goorhuis, A. ; Groot, M. ; Heijnen, A. ; Hillebregt, M.M.J. ; Hogewoning, A. ; Hommenga, M. ; Hovius, J.W. ; Janssen, Y. ; de Jong, K. ; Jongen, V. ; Kootstra, N.A. ; Koup, R.A. ; Kroon, F.P. ; van de Laar, T.J.W. ; van Leeuwen, M.M. ; Lettinga, K. ; Linde, I. ; Loomans, D.S.E. ; Mouhebati, T. ; Mulder, B.J. ; Mulder, J. ; Nellen, F.J. ; Nijsters, A. ; Nobel, H. ; Oostvogel, P. ; Op de Coul, E.L.M. ; Peters, E. ; van der Poll, T. ; Ratmann, O. ; van Rooijen, M.S. ; Schim van der Loeff, M.F. ; Schoute, W.E.M. ; Sonder, G.J. ; Veenstra, J. ; Verdult, F. ; de Vocht, J. ; de Vries, H.J. ; Vrouenraets, S. ; van Vugt, M. ; Wiersinga, W.J. ; Wit, F.W. ; Woittiez, L.R. ; Zaheri, S. ; van Zelm, M.C. ; Żakowicz, A. ; Zimmermann, H.M.L.</creator><creatorcontrib>Hoornenborg, Elske ; Coyer, Liza ; Boyd, Anders ; Achterbergh, Roel Christiaan Alfons ; Schim van der Loeff, Maarten Franciscus ; Bruisten, Sylvia ; de Vries, Henry John Christiaan ; Koopsen, Jelle ; van de Laar, Thijs J.W. ; Prins, Maria ; de Bree, G.J. ; Brokx, P. ; Heidenrijk, M. ; Prins, M. ; Reiss, P. ; van der Valk, M. ; de Bree, G.J. ; Davidovich, U. ; Geerlings, S.E. ; Hoornenborg, E. ; Oomen, A. ; Sighem, A. van ; Zuilhof, W. ; Bruinderink, M.L. Groot ; Achterbergh, R.C.A. ; Ananworanich, J. ; Van de Beek, D. ; van den Berk, G.E.L. ; Bezemer, D. ; van Bijnen, A. ; Blok, W.L. ; Bomers, M. ; Boucher, C.A.B. ; Brokking, W. ; Burger, D. ; Brinkman, K. ; de Bruin, M. ; Bruisten, S. ; Coyer, L. ; van Crevel, R. ; Daans, C.G. ; Dellemann, L. ; Dijkstra, M. ; van Duijnhoven, Y.T. ; van Eeden, A. ; Elsenburg, L. ; van den Elshout, M.A.M. ; Ester, C. ; Ersan, E. ; Felipa, P.E.V. ; Frissen, P.H.J. ; Geijtenbeek, T.B.H. ; Godfried, M.H. ; van Gool, J. ; Goorhuis, A. ; Groot, M. ; Heijnen, A. ; Hillebregt, M.M.J. ; Hogewoning, A. ; Hommenga, M. ; Hovius, J.W. ; Janssen, Y. ; de Jong, K. ; Jongen, V. ; Kootstra, N.A. ; Koup, R.A. ; Kroon, F.P. ; van de Laar, T.J.W. ; van Leeuwen, M.M. ; Lettinga, K. ; Linde, I. ; Loomans, D.S.E. ; Mouhebati, T. ; Mulder, B.J. ; Mulder, J. ; Nellen, F.J. ; Nijsters, A. ; Nobel, H. ; Oostvogel, P. ; Op de Coul, E.L.M. ; Peters, E. ; van der Poll, T. ; Ratmann, O. ; van Rooijen, M.S. ; Schim van der Loeff, M.F. ; Schoute, W.E.M. ; Sonder, G.J. ; Veenstra, J. ; Verdult, F. ; de Vocht, J. ; de Vries, H.J. ; Vrouenraets, S. ; van Vugt, M. ; Wiersinga, W.J. ; Wit, F.W. ; Woittiez, L.R. ; Zaheri, S. ; van Zelm, M.C. ; Żakowicz, A. ; Zimmermann, H.M.L. ; Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative</creatorcontrib><description>HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM). We evaluated HCV incidence and its risk factors among HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP). Participants of the Amsterdam PrEP project were tested for HCV antibodies or HCV-RNA every 6 months. Participants used daily or event-driven PrEP and could switch regimens during follow-up. We calculated incidence rates (IRs) for overall HCV infection and separately for primary and re-infection. A univariable Bayesian exponential survival model was used to identify risk factors associated with incident HCV infection. The HCV NS5B gene fragment (709 bp) was sequenced and compared to HCV isolates from HIV-positive MSM and other risk groups (n = 419) using phylogenetic analysis. Among 350 participants contributing 653.6 person-years (PYs), we detected 15 HCV infections in 14 participants (IR = 2.30/100PY). There were 8 primary infections (IR = 1.27/100PY) and 7 re-infections (IR = 27.8/100PY). IR was 2.71/100PY in daily and 1.15/100PY in event-driven PrEP users. Factors associated with incident HCV infection were higher number of receptive condomless anal sex acts with casual partners (posterior hazard ratio [HR] 1.57 per ln increase; 95% credibility interval [CrI] 1.09–2.20), anal STI (posterior HR 2.93; 95% CrI 1.24–7.13), injecting drug use (posterior HR 4.69; 95% CrI 1.61–12.09) and sharing straws when snorting drugs (posterior HR 2.62; 95% CrI 1.09–6.02). We identified robust MSM-specific HCV clusters of subtypes 1a, 4d, 2b and 3a, which included MSM with and without HIV. HIV-negative MSM using PrEP are at risk of incident HCV infection, while identified risk factors are similar to those in HIV-positive MSM. Regular HCV testing is needed, especially for those with a previous HCV infection and those reporting risk factors. We report that hepatitis C virus infections are frequently acquired among HIV-negative men who have sex with men (MSM) using pre-exposure prophylaxis to prevent HIV infection. New infections occurred more frequently in those reporting receptive anal sex without using condoms, having an anal sexually transmitted infection, injecting drugs, and sharing straws when snorting drugs. The viruses found in HIV-negative men using pre-exposure prophylaxis are genetically similar to those in HIV-positive men, but not in other hepatitis C risk groups, suggesting that (sexual) transmission is occurring between HIV-positive MSM and HIV-negative MSM using pre-exposure prophylaxis. Dutch trial registration number NTR5411. [Display omitted] •HIV-negative men who have sex with men while on pre-exposure prophylaxis are at risk of incident HCV infection.•High incidence rates of both HCV primary and re-infection were observed.•Identified HCV risk-factors were similar to those in HIV-positive men who have sex with men.•Specific clusters of HCV strains were identified in men who have sex with men, with and without HIV.•HCV-testing for HIV-negative men who have sex with men while on pre-exposure prophylaxis is recommended.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2019.11.022</identifier><identifier>PMID: 31862485</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Anal sex ; Bayesian analysis ; Condoms ; Disease transmission ; Hepatitis ; Hepatitis C ; Hepatitis C virus ; HIV ; Homosexuality ; Human immunodeficiency virus ; Infections ; Male ; Men who have sex with men ; Molecular epidemiology ; Phylogeny ; Pre-exposure prophylaxis ; Prophylaxis ; Ribonucleic acid ; Risk factors ; Risk groups ; RNA ; RNA-directed RNA polymerase</subject><ispartof>Journal of hepatology, 2020-05, Vol.72 (5), p.855-864</ispartof><rights>2019 European Association for the Study of the Liver</rights><rights>Copyright © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. May 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-3402eceed7e2a0459a932e8b07483a19e49bed29c49bbc534f7db882c835e483</citedby><cites>FETCH-LOGICAL-c428t-3402eceed7e2a0459a932e8b07483a19e49bed29c49bbc534f7db882c835e483</cites><orcidid>0000-0003-4352-5467</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2019.11.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31862485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoornenborg, Elske</creatorcontrib><creatorcontrib>Coyer, Liza</creatorcontrib><creatorcontrib>Boyd, Anders</creatorcontrib><creatorcontrib>Achterbergh, Roel Christiaan Alfons</creatorcontrib><creatorcontrib>Schim van der Loeff, Maarten Franciscus</creatorcontrib><creatorcontrib>Bruisten, Sylvia</creatorcontrib><creatorcontrib>de Vries, Henry John Christiaan</creatorcontrib><creatorcontrib>Koopsen, Jelle</creatorcontrib><creatorcontrib>van de Laar, Thijs J.W.</creatorcontrib><creatorcontrib>Prins, Maria</creatorcontrib><creatorcontrib>de Bree, G.J.</creatorcontrib><creatorcontrib>Brokx, P.</creatorcontrib><creatorcontrib>Heidenrijk, M.</creatorcontrib><creatorcontrib>Prins, M.</creatorcontrib><creatorcontrib>Reiss, P.</creatorcontrib><creatorcontrib>van der Valk, M.</creatorcontrib><creatorcontrib>de Bree, G.J.</creatorcontrib><creatorcontrib>Davidovich, U.</creatorcontrib><creatorcontrib>Geerlings, S.E.</creatorcontrib><creatorcontrib>Hoornenborg, E.</creatorcontrib><creatorcontrib>Oomen, A.</creatorcontrib><creatorcontrib>Sighem, A. van</creatorcontrib><creatorcontrib>Zuilhof, W.</creatorcontrib><creatorcontrib>Bruinderink, M.L. Groot</creatorcontrib><creatorcontrib>Achterbergh, R.C.A.</creatorcontrib><creatorcontrib>Ananworanich, J.</creatorcontrib><creatorcontrib>Van de Beek, D.</creatorcontrib><creatorcontrib>van den Berk, G.E.L.</creatorcontrib><creatorcontrib>Bezemer, D.</creatorcontrib><creatorcontrib>van Bijnen, A.</creatorcontrib><creatorcontrib>Blok, W.L.</creatorcontrib><creatorcontrib>Bomers, M.</creatorcontrib><creatorcontrib>Boucher, C.A.B.</creatorcontrib><creatorcontrib>Brokking, W.</creatorcontrib><creatorcontrib>Burger, D.</creatorcontrib><creatorcontrib>Brinkman, K.</creatorcontrib><creatorcontrib>de Bruin, M.</creatorcontrib><creatorcontrib>Bruisten, S.</creatorcontrib><creatorcontrib>Coyer, L.</creatorcontrib><creatorcontrib>van Crevel, R.</creatorcontrib><creatorcontrib>Daans, C.G.</creatorcontrib><creatorcontrib>Dellemann, L.</creatorcontrib><creatorcontrib>Dijkstra, M.</creatorcontrib><creatorcontrib>van Duijnhoven, Y.T.</creatorcontrib><creatorcontrib>van Eeden, A.</creatorcontrib><creatorcontrib>Elsenburg, L.</creatorcontrib><creatorcontrib>van den Elshout, M.A.M.</creatorcontrib><creatorcontrib>Ester, C.</creatorcontrib><creatorcontrib>Ersan, E.</creatorcontrib><creatorcontrib>Felipa, P.E.V.</creatorcontrib><creatorcontrib>Frissen, P.H.J.</creatorcontrib><creatorcontrib>Geijtenbeek, T.B.H.</creatorcontrib><creatorcontrib>Godfried, M.H.</creatorcontrib><creatorcontrib>van Gool, J.</creatorcontrib><creatorcontrib>Goorhuis, A.</creatorcontrib><creatorcontrib>Groot, M.</creatorcontrib><creatorcontrib>Heijnen, A.</creatorcontrib><creatorcontrib>Hillebregt, M.M.J.</creatorcontrib><creatorcontrib>Hogewoning, A.</creatorcontrib><creatorcontrib>Hommenga, M.</creatorcontrib><creatorcontrib>Hovius, J.W.</creatorcontrib><creatorcontrib>Janssen, Y.</creatorcontrib><creatorcontrib>de Jong, K.</creatorcontrib><creatorcontrib>Jongen, V.</creatorcontrib><creatorcontrib>Kootstra, N.A.</creatorcontrib><creatorcontrib>Koup, R.A.</creatorcontrib><creatorcontrib>Kroon, F.P.</creatorcontrib><creatorcontrib>van de Laar, T.J.W.</creatorcontrib><creatorcontrib>van Leeuwen, M.M.</creatorcontrib><creatorcontrib>Lettinga, K.</creatorcontrib><creatorcontrib>Linde, I.</creatorcontrib><creatorcontrib>Loomans, D.S.E.</creatorcontrib><creatorcontrib>Mouhebati, T.</creatorcontrib><creatorcontrib>Mulder, B.J.</creatorcontrib><creatorcontrib>Mulder, J.</creatorcontrib><creatorcontrib>Nellen, F.J.</creatorcontrib><creatorcontrib>Nijsters, A.</creatorcontrib><creatorcontrib>Nobel, H.</creatorcontrib><creatorcontrib>Oostvogel, P.</creatorcontrib><creatorcontrib>Op de Coul, E.L.M.</creatorcontrib><creatorcontrib>Peters, E.</creatorcontrib><creatorcontrib>van der Poll, T.</creatorcontrib><creatorcontrib>Ratmann, O.</creatorcontrib><creatorcontrib>van Rooijen, M.S.</creatorcontrib><creatorcontrib>Schim van der Loeff, M.F.</creatorcontrib><creatorcontrib>Schoute, W.E.M.</creatorcontrib><creatorcontrib>Sonder, G.J.</creatorcontrib><creatorcontrib>Veenstra, J.</creatorcontrib><creatorcontrib>Verdult, F.</creatorcontrib><creatorcontrib>de Vocht, J.</creatorcontrib><creatorcontrib>de Vries, H.J.</creatorcontrib><creatorcontrib>Vrouenraets, S.</creatorcontrib><creatorcontrib>van Vugt, M.</creatorcontrib><creatorcontrib>Wiersinga, W.J.</creatorcontrib><creatorcontrib>Wit, F.W.</creatorcontrib><creatorcontrib>Woittiez, L.R.</creatorcontrib><creatorcontrib>Zaheri, S.</creatorcontrib><creatorcontrib>van Zelm, M.C.</creatorcontrib><creatorcontrib>Żakowicz, A.</creatorcontrib><creatorcontrib>Zimmermann, H.M.L.</creatorcontrib><creatorcontrib>Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative</creatorcontrib><title>High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM). We evaluated HCV incidence and its risk factors among HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP). Participants of the Amsterdam PrEP project were tested for HCV antibodies or HCV-RNA every 6 months. Participants used daily or event-driven PrEP and could switch regimens during follow-up. We calculated incidence rates (IRs) for overall HCV infection and separately for primary and re-infection. A univariable Bayesian exponential survival model was used to identify risk factors associated with incident HCV infection. The HCV NS5B gene fragment (709 bp) was sequenced and compared to HCV isolates from HIV-positive MSM and other risk groups (n = 419) using phylogenetic analysis. Among 350 participants contributing 653.6 person-years (PYs), we detected 15 HCV infections in 14 participants (IR = 2.30/100PY). There were 8 primary infections (IR = 1.27/100PY) and 7 re-infections (IR = 27.8/100PY). IR was 2.71/100PY in daily and 1.15/100PY in event-driven PrEP users. Factors associated with incident HCV infection were higher number of receptive condomless anal sex acts with casual partners (posterior hazard ratio [HR] 1.57 per ln increase; 95% credibility interval [CrI] 1.09–2.20), anal STI (posterior HR 2.93; 95% CrI 1.24–7.13), injecting drug use (posterior HR 4.69; 95% CrI 1.61–12.09) and sharing straws when snorting drugs (posterior HR 2.62; 95% CrI 1.09–6.02). We identified robust MSM-specific HCV clusters of subtypes 1a, 4d, 2b and 3a, which included MSM with and without HIV. HIV-negative MSM using PrEP are at risk of incident HCV infection, while identified risk factors are similar to those in HIV-positive MSM. Regular HCV testing is needed, especially for those with a previous HCV infection and those reporting risk factors. We report that hepatitis C virus infections are frequently acquired among HIV-negative men who have sex with men (MSM) using pre-exposure prophylaxis to prevent HIV infection. New infections occurred more frequently in those reporting receptive anal sex without using condoms, having an anal sexually transmitted infection, injecting drugs, and sharing straws when snorting drugs. The viruses found in HIV-negative men using pre-exposure prophylaxis are genetically similar to those in HIV-positive men, but not in other hepatitis C risk groups, suggesting that (sexual) transmission is occurring between HIV-positive MSM and HIV-negative MSM using pre-exposure prophylaxis. Dutch trial registration number NTR5411. [Display omitted] •HIV-negative men who have sex with men while on pre-exposure prophylaxis are at risk of incident HCV infection.•High incidence rates of both HCV primary and re-infection were observed.•Identified HCV risk-factors were similar to those in HIV-positive men who have sex with men.•Specific clusters of HCV strains were identified in men who have sex with men, with and without HIV.•HCV-testing for HIV-negative men who have sex with men while on pre-exposure prophylaxis is recommended.</description><subject>Anal sex</subject><subject>Bayesian analysis</subject><subject>Condoms</subject><subject>Disease transmission</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C virus</subject><subject>HIV</subject><subject>Homosexuality</subject><subject>Human immunodeficiency virus</subject><subject>Infections</subject><subject>Male</subject><subject>Men who have sex with men</subject><subject>Molecular epidemiology</subject><subject>Phylogeny</subject><subject>Pre-exposure prophylaxis</subject><subject>Prophylaxis</subject><subject>Ribonucleic acid</subject><subject>Risk factors</subject><subject>Risk groups</subject><subject>RNA</subject><subject>RNA-directed RNA polymerase</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQhi0EglL4AwzIEgtLgr-SOBILqoAiIbFUjFiOc20ctUmwEyj_HocCAwPT6U7PvXd6EDqjJKaEpld1XFfQxYzQPKY0JoztoQlNCYlIKug-mgRIRpJl8ggde18TQjjJxSE64lSmTMhkgl7mdlVh2xhbQmMAt0s8nz2HAZ4_PEcNrHRv3wBvoMHvVYsrHRoPW_xu--prOnjbrHDnIIJt1_rBQWjarvpY6631J-hgqdceTr_rFC3ubhezefT4dP8wu3mMjGCyj7ggDAxAmQHTRCS5zjkDWZBMSK5pDiIvoGS5CbUwCRfLrCykZEbyBAIyRZe72HD6dQDfq431BtZr3UA7eMU4yzPO02REL_6gdTu4JjynmOAsSWQiaKDYjjKu9d7BUnXObrT7UJSoUb6q1ShfjfIVpSrID0vn39FDsYHyd-XHdgCudwAEFW8WnPLGjtpL68D0qmztf_mfScqUcQ</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Hoornenborg, Elske</creator><creator>Coyer, Liza</creator><creator>Boyd, Anders</creator><creator>Achterbergh, Roel Christiaan Alfons</creator><creator>Schim van der Loeff, Maarten Franciscus</creator><creator>Bruisten, Sylvia</creator><creator>de Vries, Henry John Christiaan</creator><creator>Koopsen, Jelle</creator><creator>van de Laar, Thijs J.W.</creator><creator>Prins, Maria</creator><creator>de Bree, G.J.</creator><creator>Brokx, P.</creator><creator>Heidenrijk, M.</creator><creator>Prins, M.</creator><creator>Reiss, P.</creator><creator>van der Valk, M.</creator><creator>de Bree, G.J.</creator><creator>Davidovich, U.</creator><creator>Geerlings, S.E.</creator><creator>Hoornenborg, E.</creator><creator>Oomen, A.</creator><creator>Sighem, A. van</creator><creator>Zuilhof, W.</creator><creator>Bruinderink, M.L. Groot</creator><creator>Achterbergh, R.C.A.</creator><creator>Ananworanich, J.</creator><creator>Van de Beek, D.</creator><creator>van den Berk, G.E.L.</creator><creator>Bezemer, D.</creator><creator>van Bijnen, A.</creator><creator>Blok, W.L.</creator><creator>Bomers, M.</creator><creator>Boucher, C.A.B.</creator><creator>Brokking, W.</creator><creator>Burger, D.</creator><creator>Brinkman, K.</creator><creator>de Bruin, M.</creator><creator>Bruisten, S.</creator><creator>Coyer, L.</creator><creator>van Crevel, R.</creator><creator>Daans, C.G.</creator><creator>Dellemann, L.</creator><creator>Dijkstra, M.</creator><creator>van Duijnhoven, Y.T.</creator><creator>van Eeden, A.</creator><creator>Elsenburg, L.</creator><creator>van den Elshout, M.A.M.</creator><creator>Ester, C.</creator><creator>Ersan, E.</creator><creator>Felipa, P.E.V.</creator><creator>Frissen, P.H.J.</creator><creator>Geijtenbeek, T.B.H.</creator><creator>Godfried, M.H.</creator><creator>van Gool, J.</creator><creator>Goorhuis, A.</creator><creator>Groot, M.</creator><creator>Heijnen, A.</creator><creator>Hillebregt, M.M.J.</creator><creator>Hogewoning, A.</creator><creator>Hommenga, M.</creator><creator>Hovius, J.W.</creator><creator>Janssen, Y.</creator><creator>de Jong, K.</creator><creator>Jongen, V.</creator><creator>Kootstra, N.A.</creator><creator>Koup, R.A.</creator><creator>Kroon, F.P.</creator><creator>van de Laar, T.J.W.</creator><creator>van Leeuwen, M.M.</creator><creator>Lettinga, K.</creator><creator>Linde, I.</creator><creator>Loomans, D.S.E.</creator><creator>Mouhebati, T.</creator><creator>Mulder, B.J.</creator><creator>Mulder, J.</creator><creator>Nellen, F.J.</creator><creator>Nijsters, A.</creator><creator>Nobel, H.</creator><creator>Oostvogel, P.</creator><creator>Op de Coul, E.L.M.</creator><creator>Peters, E.</creator><creator>van der Poll, T.</creator><creator>Ratmann, O.</creator><creator>van Rooijen, M.S.</creator><creator>Schim van der Loeff, M.F.</creator><creator>Schoute, W.E.M.</creator><creator>Sonder, G.J.</creator><creator>Veenstra, J.</creator><creator>Verdult, F.</creator><creator>de Vocht, J.</creator><creator>de Vries, H.J.</creator><creator>Vrouenraets, S.</creator><creator>van Vugt, M.</creator><creator>Wiersinga, W.J.</creator><creator>Wit, F.W.</creator><creator>Woittiez, L.R.</creator><creator>Zaheri, S.</creator><creator>van Zelm, M.C.</creator><creator>Żakowicz, A.</creator><creator>Zimmermann, H.M.L.</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4352-5467</orcidid></search><sort><creationdate>202005</creationdate><title>High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis</title><author>Hoornenborg, Elske ; Coyer, Liza ; Boyd, Anders ; Achterbergh, Roel Christiaan Alfons ; Schim van der Loeff, Maarten Franciscus ; Bruisten, Sylvia ; de Vries, Henry John Christiaan ; Koopsen, Jelle ; van de Laar, Thijs J.W. ; Prins, Maria ; de Bree, G.J. ; Brokx, P. ; Heidenrijk, M. ; Prins, M. ; Reiss, P. ; van der Valk, M. ; de Bree, G.J. ; Davidovich, U. ; Geerlings, S.E. ; Hoornenborg, E. ; Oomen, A. ; Sighem, A. van ; Zuilhof, W. ; Bruinderink, M.L. Groot ; Achterbergh, R.C.A. ; Ananworanich, J. ; Van de Beek, D. ; van den Berk, G.E.L. ; Bezemer, D. ; van Bijnen, A. ; Blok, W.L. ; Bomers, M. ; Boucher, C.A.B. ; Brokking, W. ; Burger, D. ; Brinkman, K. ; de Bruin, M. ; Bruisten, S. ; Coyer, L. ; van Crevel, R. ; Daans, C.G. ; Dellemann, L. ; Dijkstra, M. ; van Duijnhoven, Y.T. ; van Eeden, A. ; Elsenburg, L. ; van den Elshout, M.A.M. ; Ester, C. ; Ersan, E. ; Felipa, P.E.V. ; Frissen, P.H.J. ; Geijtenbeek, T.B.H. ; Godfried, M.H. ; van Gool, J. ; Goorhuis, A. ; Groot, M. ; Heijnen, A. ; Hillebregt, M.M.J. ; Hogewoning, A. ; Hommenga, M. ; Hovius, J.W. ; Janssen, Y. ; de Jong, K. ; Jongen, V. ; Kootstra, N.A. ; Koup, R.A. ; Kroon, F.P. ; van de Laar, T.J.W. ; van Leeuwen, M.M. ; Lettinga, K. ; Linde, I. ; Loomans, D.S.E. ; Mouhebati, T. ; Mulder, B.J. ; Mulder, J. ; Nellen, F.J. ; Nijsters, A. ; Nobel, H. ; Oostvogel, P. ; Op de Coul, E.L.M. ; Peters, E. ; van der Poll, T. ; Ratmann, O. ; van Rooijen, M.S. ; Schim van der Loeff, M.F. ; Schoute, W.E.M. ; Sonder, G.J. ; Veenstra, J. ; Verdult, F. ; de Vocht, J. ; de Vries, H.J. ; Vrouenraets, S. ; van Vugt, M. ; Wiersinga, W.J. ; Wit, F.W. ; Woittiez, L.R. ; Zaheri, S. ; van Zelm, M.C. ; Żakowicz, A. ; Zimmermann, H.M.L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-3402eceed7e2a0459a932e8b07483a19e49bed29c49bbc534f7db882c835e483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anal sex</topic><topic>Bayesian analysis</topic><topic>Condoms</topic><topic>Disease transmission</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C virus</topic><topic>HIV</topic><topic>Homosexuality</topic><topic>Human immunodeficiency virus</topic><topic>Infections</topic><topic>Male</topic><topic>Men who have sex with men</topic><topic>Molecular epidemiology</topic><topic>Phylogeny</topic><topic>Pre-exposure prophylaxis</topic><topic>Prophylaxis</topic><topic>Ribonucleic acid</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>RNA</topic><topic>RNA-directed RNA polymerase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoornenborg, Elske</creatorcontrib><creatorcontrib>Coyer, Liza</creatorcontrib><creatorcontrib>Boyd, Anders</creatorcontrib><creatorcontrib>Achterbergh, Roel Christiaan Alfons</creatorcontrib><creatorcontrib>Schim van der Loeff, Maarten Franciscus</creatorcontrib><creatorcontrib>Bruisten, Sylvia</creatorcontrib><creatorcontrib>de Vries, Henry John Christiaan</creatorcontrib><creatorcontrib>Koopsen, Jelle</creatorcontrib><creatorcontrib>van de Laar, Thijs J.W.</creatorcontrib><creatorcontrib>Prins, Maria</creatorcontrib><creatorcontrib>de Bree, G.J.</creatorcontrib><creatorcontrib>Brokx, P.</creatorcontrib><creatorcontrib>Heidenrijk, M.</creatorcontrib><creatorcontrib>Prins, M.</creatorcontrib><creatorcontrib>Reiss, P.</creatorcontrib><creatorcontrib>van der Valk, M.</creatorcontrib><creatorcontrib>de Bree, G.J.</creatorcontrib><creatorcontrib>Davidovich, U.</creatorcontrib><creatorcontrib>Geerlings, S.E.</creatorcontrib><creatorcontrib>Hoornenborg, E.</creatorcontrib><creatorcontrib>Oomen, A.</creatorcontrib><creatorcontrib>Sighem, A. van</creatorcontrib><creatorcontrib>Zuilhof, W.</creatorcontrib><creatorcontrib>Bruinderink, M.L. Groot</creatorcontrib><creatorcontrib>Achterbergh, R.C.A.</creatorcontrib><creatorcontrib>Ananworanich, J.</creatorcontrib><creatorcontrib>Van de Beek, D.</creatorcontrib><creatorcontrib>van den Berk, G.E.L.</creatorcontrib><creatorcontrib>Bezemer, D.</creatorcontrib><creatorcontrib>van Bijnen, A.</creatorcontrib><creatorcontrib>Blok, W.L.</creatorcontrib><creatorcontrib>Bomers, M.</creatorcontrib><creatorcontrib>Boucher, C.A.B.</creatorcontrib><creatorcontrib>Brokking, W.</creatorcontrib><creatorcontrib>Burger, D.</creatorcontrib><creatorcontrib>Brinkman, K.</creatorcontrib><creatorcontrib>de Bruin, M.</creatorcontrib><creatorcontrib>Bruisten, S.</creatorcontrib><creatorcontrib>Coyer, L.</creatorcontrib><creatorcontrib>van Crevel, R.</creatorcontrib><creatorcontrib>Daans, C.G.</creatorcontrib><creatorcontrib>Dellemann, L.</creatorcontrib><creatorcontrib>Dijkstra, M.</creatorcontrib><creatorcontrib>van Duijnhoven, Y.T.</creatorcontrib><creatorcontrib>van Eeden, A.</creatorcontrib><creatorcontrib>Elsenburg, L.</creatorcontrib><creatorcontrib>van den Elshout, M.A.M.</creatorcontrib><creatorcontrib>Ester, C.</creatorcontrib><creatorcontrib>Ersan, E.</creatorcontrib><creatorcontrib>Felipa, P.E.V.</creatorcontrib><creatorcontrib>Frissen, P.H.J.</creatorcontrib><creatorcontrib>Geijtenbeek, T.B.H.</creatorcontrib><creatorcontrib>Godfried, M.H.</creatorcontrib><creatorcontrib>van Gool, J.</creatorcontrib><creatorcontrib>Goorhuis, A.</creatorcontrib><creatorcontrib>Groot, M.</creatorcontrib><creatorcontrib>Heijnen, A.</creatorcontrib><creatorcontrib>Hillebregt, M.M.J.</creatorcontrib><creatorcontrib>Hogewoning, A.</creatorcontrib><creatorcontrib>Hommenga, M.</creatorcontrib><creatorcontrib>Hovius, J.W.</creatorcontrib><creatorcontrib>Janssen, Y.</creatorcontrib><creatorcontrib>de Jong, K.</creatorcontrib><creatorcontrib>Jongen, V.</creatorcontrib><creatorcontrib>Kootstra, N.A.</creatorcontrib><creatorcontrib>Koup, R.A.</creatorcontrib><creatorcontrib>Kroon, F.P.</creatorcontrib><creatorcontrib>van de Laar, T.J.W.</creatorcontrib><creatorcontrib>van Leeuwen, M.M.</creatorcontrib><creatorcontrib>Lettinga, K.</creatorcontrib><creatorcontrib>Linde, I.</creatorcontrib><creatorcontrib>Loomans, D.S.E.</creatorcontrib><creatorcontrib>Mouhebati, T.</creatorcontrib><creatorcontrib>Mulder, B.J.</creatorcontrib><creatorcontrib>Mulder, J.</creatorcontrib><creatorcontrib>Nellen, F.J.</creatorcontrib><creatorcontrib>Nijsters, A.</creatorcontrib><creatorcontrib>Nobel, H.</creatorcontrib><creatorcontrib>Oostvogel, P.</creatorcontrib><creatorcontrib>Op de Coul, E.L.M.</creatorcontrib><creatorcontrib>Peters, E.</creatorcontrib><creatorcontrib>van der Poll, T.</creatorcontrib><creatorcontrib>Ratmann, O.</creatorcontrib><creatorcontrib>van Rooijen, M.S.</creatorcontrib><creatorcontrib>Schim van der Loeff, M.F.</creatorcontrib><creatorcontrib>Schoute, W.E.M.</creatorcontrib><creatorcontrib>Sonder, G.J.</creatorcontrib><creatorcontrib>Veenstra, J.</creatorcontrib><creatorcontrib>Verdult, F.</creatorcontrib><creatorcontrib>de Vocht, J.</creatorcontrib><creatorcontrib>de Vries, H.J.</creatorcontrib><creatorcontrib>Vrouenraets, S.</creatorcontrib><creatorcontrib>van Vugt, M.</creatorcontrib><creatorcontrib>Wiersinga, W.J.</creatorcontrib><creatorcontrib>Wit, F.W.</creatorcontrib><creatorcontrib>Woittiez, L.R.</creatorcontrib><creatorcontrib>Zaheri, S.</creatorcontrib><creatorcontrib>van Zelm, M.C.</creatorcontrib><creatorcontrib>Żakowicz, A.</creatorcontrib><creatorcontrib>Zimmermann, H.M.L.</creatorcontrib><creatorcontrib>Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoornenborg, Elske</au><au>Coyer, Liza</au><au>Boyd, Anders</au><au>Achterbergh, Roel Christiaan Alfons</au><au>Schim van der Loeff, Maarten Franciscus</au><au>Bruisten, Sylvia</au><au>de Vries, Henry John Christiaan</au><au>Koopsen, Jelle</au><au>van de Laar, Thijs J.W.</au><au>Prins, Maria</au><au>de Bree, G.J.</au><au>Brokx, P.</au><au>Heidenrijk, M.</au><au>Prins, M.</au><au>Reiss, P.</au><au>van der Valk, M.</au><au>de Bree, G.J.</au><au>Davidovich, U.</au><au>Geerlings, S.E.</au><au>Hoornenborg, E.</au><au>Oomen, A.</au><au>Sighem, A. van</au><au>Zuilhof, W.</au><au>Bruinderink, M.L. Groot</au><au>Achterbergh, R.C.A.</au><au>Ananworanich, J.</au><au>Van de Beek, D.</au><au>van den Berk, G.E.L.</au><au>Bezemer, D.</au><au>van Bijnen, A.</au><au>Blok, W.L.</au><au>Bomers, M.</au><au>Boucher, C.A.B.</au><au>Brokking, W.</au><au>Burger, D.</au><au>Brinkman, K.</au><au>de Bruin, M.</au><au>Bruisten, S.</au><au>Coyer, L.</au><au>van Crevel, R.</au><au>Daans, C.G.</au><au>Dellemann, L.</au><au>Dijkstra, M.</au><au>van Duijnhoven, Y.T.</au><au>van Eeden, A.</au><au>Elsenburg, L.</au><au>van den Elshout, M.A.M.</au><au>Ester, C.</au><au>Ersan, E.</au><au>Felipa, P.E.V.</au><au>Frissen, P.H.J.</au><au>Geijtenbeek, T.B.H.</au><au>Godfried, M.H.</au><au>van Gool, J.</au><au>Goorhuis, A.</au><au>Groot, M.</au><au>Heijnen, A.</au><au>Hillebregt, M.M.J.</au><au>Hogewoning, A.</au><au>Hommenga, M.</au><au>Hovius, J.W.</au><au>Janssen, Y.</au><au>de Jong, K.</au><au>Jongen, V.</au><au>Kootstra, N.A.</au><au>Koup, R.A.</au><au>Kroon, F.P.</au><au>van de Laar, T.J.W.</au><au>van Leeuwen, M.M.</au><au>Lettinga, K.</au><au>Linde, I.</au><au>Loomans, D.S.E.</au><au>Mouhebati, T.</au><au>Mulder, B.J.</au><au>Mulder, J.</au><au>Nellen, F.J.</au><au>Nijsters, A.</au><au>Nobel, H.</au><au>Oostvogel, P.</au><au>Op de Coul, E.L.M.</au><au>Peters, E.</au><au>van der Poll, T.</au><au>Ratmann, O.</au><au>van Rooijen, M.S.</au><au>Schim van der Loeff, M.F.</au><au>Schoute, W.E.M.</au><au>Sonder, G.J.</au><au>Veenstra, J.</au><au>Verdult, F.</au><au>de Vocht, J.</au><au>de Vries, H.J.</au><au>Vrouenraets, S.</au><au>van Vugt, M.</au><au>Wiersinga, W.J.</au><au>Wit, F.W.</au><au>Woittiez, L.R.</au><au>Zaheri, S.</au><au>van Zelm, M.C.</au><au>Żakowicz, A.</au><au>Zimmermann, H.M.L.</au><aucorp>Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2020-05</date><risdate>2020</risdate><volume>72</volume><issue>5</issue><spage>855</spage><epage>864</epage><pages>855-864</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>HCV has emerged as a sexually transmitted infection (STI) among HIV-positive men who have sex with men (MSM). We evaluated HCV incidence and its risk factors among HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP). Participants of the Amsterdam PrEP project were tested for HCV antibodies or HCV-RNA every 6 months. Participants used daily or event-driven PrEP and could switch regimens during follow-up. We calculated incidence rates (IRs) for overall HCV infection and separately for primary and re-infection. A univariable Bayesian exponential survival model was used to identify risk factors associated with incident HCV infection. The HCV NS5B gene fragment (709 bp) was sequenced and compared to HCV isolates from HIV-positive MSM and other risk groups (n = 419) using phylogenetic analysis. Among 350 participants contributing 653.6 person-years (PYs), we detected 15 HCV infections in 14 participants (IR = 2.30/100PY). There were 8 primary infections (IR = 1.27/100PY) and 7 re-infections (IR = 27.8/100PY). IR was 2.71/100PY in daily and 1.15/100PY in event-driven PrEP users. Factors associated with incident HCV infection were higher number of receptive condomless anal sex acts with casual partners (posterior hazard ratio [HR] 1.57 per ln increase; 95% credibility interval [CrI] 1.09–2.20), anal STI (posterior HR 2.93; 95% CrI 1.24–7.13), injecting drug use (posterior HR 4.69; 95% CrI 1.61–12.09) and sharing straws when snorting drugs (posterior HR 2.62; 95% CrI 1.09–6.02). We identified robust MSM-specific HCV clusters of subtypes 1a, 4d, 2b and 3a, which included MSM with and without HIV. HIV-negative MSM using PrEP are at risk of incident HCV infection, while identified risk factors are similar to those in HIV-positive MSM. Regular HCV testing is needed, especially for those with a previous HCV infection and those reporting risk factors. We report that hepatitis C virus infections are frequently acquired among HIV-negative men who have sex with men (MSM) using pre-exposure prophylaxis to prevent HIV infection. New infections occurred more frequently in those reporting receptive anal sex without using condoms, having an anal sexually transmitted infection, injecting drugs, and sharing straws when snorting drugs. The viruses found in HIV-negative men using pre-exposure prophylaxis are genetically similar to those in HIV-positive men, but not in other hepatitis C risk groups, suggesting that (sexual) transmission is occurring between HIV-positive MSM and HIV-negative MSM using pre-exposure prophylaxis. Dutch trial registration number NTR5411. [Display omitted] •HIV-negative men who have sex with men while on pre-exposure prophylaxis are at risk of incident HCV infection.•High incidence rates of both HCV primary and re-infection were observed.•Identified HCV risk-factors were similar to those in HIV-positive men who have sex with men.•Specific clusters of HCV strains were identified in men who have sex with men, with and without HIV.•HCV-testing for HIV-negative men who have sex with men while on pre-exposure prophylaxis is recommended.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>31862485</pmid><doi>10.1016/j.jhep.2019.11.022</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4352-5467</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0168-8278
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issn 0168-8278
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subjects Anal sex
Bayesian analysis
Condoms
Disease transmission
Hepatitis
Hepatitis C
Hepatitis C virus
HIV
Homosexuality
Human immunodeficiency virus
Infections
Male
Men who have sex with men
Molecular epidemiology
Phylogeny
Pre-exposure prophylaxis
Prophylaxis
Ribonucleic acid
Risk factors
Risk groups
RNA
RNA-directed RNA polymerase
title High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis
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