11th Annual Conference Of The British HIV Association [BHIVA] 20–23 April 2005, Burlington Hotel·Dublin·Ireland

[AUTHOR(S):] M Danta¹, D Brown¹, O Pybus⁶, M Nelson⁴, M Fisher⁵, C Sabin³, S Bhagani² for the HIV and Acute HCV (HAAC) group.
¹Centre for Hepatology, ²Dept of HIV Medicine, ³Dept of Primary Care and Population Sciences, Royal Free and University College Medical School, ⁴Dept of HIV Medicine, Chelsea and Westminster Hospitals, London, ⁵Dept of HIV Medicine, Brighton and Sussex University Hospitals Trust, Brighton, ⁶Dept of Zoology, Oxford University, Oxford, UK

BHIVA Conf 2005 Apr 20-23;11:O25

AIMS: To characterise the mode of acute HCV transmission in HIV-infected individuals using linked molecular and clinical epidemiological analysis.

METHODS: Patients enrolled had a seroconversion to anti-HCV + and positive HCV PCR within 9 months. The E1/E2 region of the HCV genome from each patient's serum was amplified with RT-PCR and sequenced. Using PAUP* software, a phylogenetic tree was constructed from the amplified sequences, comparing them with unrelated E1/E2 sequences. A case-control study using a questionnaire instrument to determine transmission factors was performed using HIV mono-infected controls from each clinic's database, matching for age, length of HIV infection and HAART.

RESULTS: 90 HIV-positive homosexual males (mean age 36 yrs) with acute HCV have been identified. Phylogenetic analysis of 55 E1/E2 sequences reveals multiple monophyletic clades signifying that several independent HCV lineages (clades) are co-circulating in this population. The largest clade involves 21 patients. Preliminary factors identified more commonly in cases (n=23) vs controls (n=48) are: unprotected receptive and insertive anal intercourse (P<0.001), mucosally traumatic practices including fisting (P<0.001) and use of sex toys (P<0.001), group sex (87% Vs 52.3%, P=0.01), and sexual activity while feeling the effects of drugs (100% Vs 64%, P<0.003).

CONCLUSIONS: Mucosally traumatic sexual factors are significantly associated with the recent transmission of HCV.

PRESENTING AUTHOR:

Download Presentation

2005-04-20
O25

Copyright © 2005 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD