Low Spontaneous Clearance Rates of Recently Acquired Hepatitis C Virus in Human Immunodeficiency Virus–Positive Men Who Have Sex With Men (PROBE-C Study)

作者：Malte B. Monin, Patrick Ingiliz, Thomas A. Lutz, Stefan Scholten, Christiane Cordes, Maria Martínez‐Rebollar, Christoph D. Spinner, Mark Nelson, Michael Rausch, Sanjay Bhagani, Lars Peters, Thomas Reiberger, Stefan Mauss, Jürgen K. Rockstroh, Christoph Boesecke, for the PROBE-C study group · 发表于：Clinical Infectious Diseases · 年份：2022 · DOI：10.1093/cid/ciac680 · 被引用次数：14 · 研究领域：Hepatitis C virus research、HIV/AIDS drug development and treatment、HIV-related health complications and treatments

BACKGROUND: Using direct-acting antivirals (DAAs) for recently acquired hepatitis C virus (RAHCV) infections, particularly in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), dramatically reduced the incidence of hepatitis C. However, implementation into clinical practice is challenging. The aim of this study was to analyze spontaneous clearance (SC) rates of RAHCV and to identify predictors of SC. METHODS: The PROBE-C study is an observational European cohort on RAHCV infections in HIV-positive MSM. Between 2007 and 2017, RAHCV infections were documented with ≥12 months of follow-up. Fisher exact, χ2, and Mann-Whitney U tests were used for statistical analysis. RESULTS: A total of 464 RAHCV infections were documented; 457 of 464 patients (98%) were male, and the median age (interquartile range [IQR]) was 41 (38-46) years. The main risk group for hepatitis C virus (HCV) transmission was MSM (98.9%). Most participants were infected with HCV genotype 1 (78.3%). The median baseline HCV RNA level (IQR) was 230 000 (135 000-474 432) IU/mL, and the median CD4+ T-cell count was 574/µL (547-604/µL. Of all cases, 92% received combination antiretroviral therapy, with 91% showing suppressed HIV RNA levels (<200 copies/mL). The median maximum alanine aminotransferase level (IQR) was 445 (402-522) U/L. SC of RAHCV infection occurred in 55 of 464 cases (11.9%). A >2-log decline in HCV RNA levels 4 weeks after diagnosis of RAHCV infection was the strongest predic...