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Virology research J 2017 Vol 1 Issue 2
July 26-27, 2017 | Vancouver, Canada
WORLD CONFERENCE ON STDs, STIs & HIV/AIDS
allied
academies
Acute HCV and HAV in men having sex with men: An emerging epidemic in the era of highly active
antiretroviral therapy
Antonio Mastroianni
Presidio Ospedaliero "G.B. Morgagni-L. Pierantoni", Italy
M
en who have sex with men (MSM) are at risk for
acquiring hepatitis A virus (HAV), hepatitis B virus
(HBV), and hepatitis C virus (HCV) and must be vaccinated
at an early age to prevent acquisition of HAV and HBV. Acute
HCV and acute HAV infection are frequently a missed or
delayed diagnosis bc largely asymptomatic. Fewer than 20%
of patients have characteristic symptoms and unexplained
elevations in transaminases may be the only laboratory
finding.
HCV has been traditionally known to be transmitted
parenterally and HAV through fecal-oral transmission from
person-to-person contact, while not efficiently transmitted
through sexual contact. Since 2000, epidemics of acute
HCV infection in HIV‐infected MSM have been reported,
predominantly in Western Europe, Australia, and the United
States. Certain sexual risk behaviors have been hypothesized
to be associated with the acquisition of acute HCV infection
in this population: unprotected anal intercourse, fisting,
enema use, bleeding during intercourse.
Group sex practices and unsafe sexual partices were all
associated with acute HCV infection in recent different
studies. HAV outbreaks occurred among MSM throughout
the world in the 1990s and sexual activity is probably the
major mode of transmission among homosexual and bisexual
men. Acute HAV infection may have an impact on HIV viral
load. The interactions between HIV and HAV may prolong
the HAV viremia compared with non-HIV-infected individuals
which may result in a prolonged duration of risk of HAV
transmission to others, and may also increase the risk of HIV
transmission. Some studies suggest that acute hepatitis A
may increase HIV-1 viral load that may not return to baseline
after infection is resolved. MSM are at increased risk for HAV
infection, and risk factors include high number of sexual
partners and sexual practices involving oro-anal contact,
however limited data suggest low rates of HAV vaccination
in this population, particularly among young MSM. HIV-
infected MSM who do not participate in intravenous drug
use have essentially the same rate of hcv infection as the
general population, however, in the last few years, there
have been a number of reports of acute HCV infection due
to sexual transmission in the HIV-infected MSM in urban
centers in Europe and in the US. Health-care workers often
do not ask about risk behaviors during health-care visits,
resulting in missed opportunities to vaccinate persons in
high-risk groups against HAV and HBV infection. Reciprocal
interactions between HIV and HCV or HAV can increase risk
of morbidity and mortality in HIV disease and/or worsened
the natural course of the hepatitis viruses. Healthcare
workers should maintain a high grade of clinical suspicion
to identify the transmission risk factors for prevention of
reinfection, to recognize HAV and HCV in the acute stage of
infection to preventing liver related morbidity and mortality
in patients with HIV infection and to decrease the risk of
HCV transmission to susceptible hosts. The prevention of
HAV and HCV infections in the setting of co-infection with
HIV is critical because of reciprocal interactions between the
viruses that can lead to an increase risk of morbidity and
mortality.
Speaker Biography
Antonio Mastroianni, M.D, graduated and specialized in Infectious and Tropical
Diseases at the University of Bologna. July 1996–May 2017 working as a medical
physician specialist in Infectious Diseases & Tropical Diseases with a “High degree in
antibiotic and antifungal treatment” at Infectious Diseases Unit of the “G.B.Morgagni
– L. Pierantoni”, Hospital,Forlì, Italy. June 2017 Director of Infectious Diseases Unit
"Annunziata" Hospital, Cosenza, Italy. Master of Tropical Medicine (University of Siena),
Master of Diagnostic Pathways and Management of Sexually Transmitted Infections
(Bologna, ECCMID), Master of Sepsis & Septic Shock (Univeristy of Milan), Master of
Hospital Infections (University of Milan-Bicocca), Master of Tuberculosis (University of
Brescia), Master of Pediatric Infections (University of Florence), Master of Infections
in Pregnancy (University of Brescia). Mastroianni has authored more than 150 peer
reviewed publications in indexed Journals as Clinical Infectious Diseases, AIDS, AIDS
Care, Journal of Chemotherapy, Clinical Microbiology & Infection, Europen Journal of
Clinical Microbiology & Infectious Diseases, Journal of Infection.
e:
antoniomastroianni@yahoo.it