Echoing past findings coming largely from Europe, a report from the Fenway Institute in Boston finds a high, 1.6 percent annual incidence of hepatitis C virus (HCV) infection among its large population of HIV-positive gay men; researchers there speculate sexual transmission and non-injection drug use were the most likely causes, according to aidsmap. Publishing their findings in the online edition of Clinical Infectious Diseases, the researchers conducted a retrospective study of all men with HIV who came to the clinic at least twice between June 2008 and June 2009. The investigators then drew data from the patients’ files to ascertain both the prevalence and the incidence of hep C infection between 2007 and 2009.

Of the 1,160 HIV-positive gay men included in the cohort, 1,059 (91 percent) had at least one test for hep C. A total of 379 men who had more than one test became infected with the virus, across 1,408 person-years of follow-up, for an incidence of 1.6 cases per 100 person-years. A third of those men with prevalent and incident hep C reported injection drug use, while 46 percent reported non-injection drug use (cocaine was the most common) and 16 percent said they had not used drugs.

The investigators speculate that traumatic sexual practices such as fisting may aid in hep C transmission among this population. Non-injection drugs are another potential source, considering, for example, that cocaine straws can serve as a conduit for the virus between nasal passages.

The authors recommend that HIV-positive gay men test annually for hep C and that those who use recreational drugs or engage in unprotected sex should receive sexual risk reduction education.

To read the aidsmap report, click here.

To read the study abstract, click here.