Researchers in New York City have reported uncovering a new epidemic of hepatitis C virus infection among men who have sex with men and who have HIV infection. Researchers have previously reported unusually rapid fibrosis progression due to new HCV in MSM who have HIV infection and now expand on their findings, demonstrating that sexual transmission rather than injection-drug use is the route of infection.

Treatment is highly successful if started early in the course of infection; however, they report ominous news about liver disease progression. "This epidemic represents a new clinical syndrome for HCV infection that turns much of our knowledge on its ear: a new risk group becoming infected through a previously rare route of transmission resulting in unprecedented progression of liver fibrosis," says Daniel Fierer, MD, principal investigator on this study.

In an analysis of 21 HCV-infected patients matched with uninfected controls, unprotected receptive anal and oral sex were significantly associated with new HCV infection. Neither current nor prior injection-drug use was associated with HCV infection. In addition, treatment with pegylated interferon and ribavirin, initiated within six months of diagnosis, was completed in 16 patients with genotype 1 HCV infection; 75% achieved sustained viral response (SVR), compared to the 15% to 30% SVR rate expected with chronic genotype 1 HCV infection.

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