Doctors at Kaiser Permanente in San Francisco have reported that two previously hepatitis C negative men who have sex with men have contracted the virus through sexual activity and while on PrEP. The news was reported in the Feb. 19 edition of Clinical Infectious Diseases.
AIDSMap reports the two men were part of a cohort of people receiving the HIV prevention drug through the health programs. There were 485 people who started the drug between February 2011 and December 2014.
Hep C hadn't been thought as sexually transmitted. But the study that underscored that finding relied on heterosexual couples. Recent studies have found probable sexual transmission of the virus — which attacks the liver — in men who have sex with men in the U.S., Europe and Australia.
AIDSMap reports that the two men had recent infections of gonorrhea, syphilis and chlamydia. One man reported receptive anal sex with a person who had a piercing in his penis, the other reported no risk factors other than sexual contact with other men. Hep C is associated with blood-to-blood transfer, and the exact mechanism for sexual transmission between men is not fully understood. Hep C among MSM has been associated with anal sex, fisting, using sex toys, having multiple sex partners, sex in public venues, use of non-injected recreational drugs, sex while using drugs and having other STDs.
"I'm comfortable saying both are (from) sexual transmission," Brad Hare of Kaiser told AIDSMap.
As a result of the findings, Hare and associates are encouraging clinicians to add increased hepatitis C testing to PrEP routines.
Also of note, Kaiser, which is believed to be the largest PrEP provider in the U.S., reported in December that it had found no HIV infections among patients on PrEP.
San Francisco Doctors Report Two Hepatitis C Infections Among PrEP Users
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