Browsing by Author "Spearman, C Wendy"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Open Access
    Hepatitis C prevalence in HIV infected heterosexual men and men who have sex with men
    (2018) Gogela, Neliswa Antonia; Sonderup, Mark Wayne; Spearman, C Wendy
    Background: Globally 1% of individuals are infected with hepatitis C virus (HCV). In South Africa (SA), the prevalence ranges between 0.3% - 1% with few prospective screening data available. Similarly, local data on transmission modes of HCV are limited but probably include parenteral routes and pre-1992 blood or blood product products. The risk of heterosexually transmission is low but is increased in men who have sex with men (MSM) with co- transmission risk of both HIV and HCV. Objectives: Given a limited local understanding, we sought to better understand HCV characteristics and prevalence in 2 groups of HIV-infected men. Methods: HIV positive men in the greater Cape Town metropolitan area were recruited. Sexual orientation was self-identified and demographic and other personal data obtained via a confidentially administered questionnaire. Participants were screened for HCV after a blood draw and positive HCV Ab tests were tested for HCV RNA. Risk factors associated with HCV seropositivity were determined. Results: Five hundred HIV positive men were recruited; 215 (43%) non-MSM and 285 (57%) MSM, with median age 36 years (IQR 20 – 64) and 37 years (IQR 21 – 56), in the MSM and non-MSM group, respectively, p = NS. Overall, 3.4% (n=17) screened HCV positive, 5.6% (n=16) MSM and 0.5% (n=1) non-MSM, with 82.4% viremic for HCV RNA. In respect to genotype (GT) distribution, 50% were infected with GT1, 14.3% GT4 and 35.7% were GT2. In terms of risk, MSM were more likely to have used drugs (54.4% vs. 30.2%, p<0.001) and to have used all five modes of drugs administration (13% of MSM vs. 0.5% of non- MSM for injected drugs, 36.1% vs. 2.3% inhaled, 10% vs. 0% for the rectal route, 48.1% vs. 28.8% for smoked and 27.4% vs. 2.3% for oral drugs). More MSM than non-MSM (46.3% vs. 16.7%) reported sex whilst using recreational drugs and similarly more MSM (21.4% vs. 14%) reported having sex with a sex worker (SW).Risk factors for HCV seropositivity included drug use history (odds ratio (OR) 6.28, 98% confidence interval (CI). 1.78 – 22.12: p=0.004) and in MSM, sex with SW (OR 5.5, 95% 2.06 – 14.68; p=0.001) or use of recreational drugs with sex (OR 6.88, 95% CI 2.21 -21.44; p=0.001). Conclusion: HCV prevalence in HIV positive MSM is higher than previously appreciated or documented in South Africa. Risk factors include injecting drug use, use of recreational drugs with sex and sex with SWs. Targeted interventions are required to address this emerging challenge to achieve the viral hepatitis elimination ideal by 2030.
  • Thumbnail Image
    Item
    Open Access
    Highlights from the 3rd international HIV/viral hepatitis Co-infection meeting - HIV/viral hepatitis: improving diagnosis, antiviral therapy and access
    (BioMed Central, 2017-04-20) Maponga, Tongai G; Matsha, Matteau Rachel; Morin, Sébastien; Scheibe, Andrew; Swan, Tracy; Andrieux-Meyer, Isabelle; Spearman, C Wendy; Klein, Marina B; Rockstroh, Jürgen Kurt
    The International AIDS Society convened the 3rd International HIV/Viral Hepatitis Co-Infection Meeting on 17 July 2016 as part of the pre-conference program preceding the 21st International AIDS Conference held in Durban, South Africa. The meeting brought together a diversity of scientific, technical and community interests to discuss opportunities and challenges for increased prevention, diagnosis and treatment of viral hepatitis in people living with HIV, particularly in low- and middle-income settings. The objectives of the meeting were: i. To review the latest therapeutic developments in viral hepatitis; ii. To identify challenges such as high cost of medications for hepatitis C virus (HCV) and risk of developing viral resistance, and successes, such as the provision of HCV treatment in community-based settings, movements to reduce drug costs and increasing access, in relation to scaling up diagnosis, screening, antiviral treatment and prevention of viral hepatitis; iii. To advance the agenda for elimination of viral hepatitis as a public health problem. Discussions centred around the six key interventions outlined by the World Health Organization Global Health Sector Strategy on Viral Hepatitis 2016–2021: hepatitis B virus (HBV) vaccination (including birth dose); safe injection practices plus safe blood; harm reduction among people who inject drugs; safer sex practices; hepatitis B treatment; and hepatitis C cure. This article summarizes the main issues and findings discussed during the pre-conference meeting. One of the recommendations from the meeting delegates is universal implementation of birth dose vaccination for HBV without further delay to prevent mother-to-child transmission of infection. There is also the need to implement screening and treatment of hepatitis among pregnant women. A call was made for concerted efforts to be put together by all stakeholders towards addressing some of the structural barriers, including criminalization of drug use, discrimination and stigma that people living with viral hepatitis face. Finally, the need for greater advocacy was highlighted to enable access to therapy of viral hepatitis at lower cost than currently prevails. Implementation of these resolutions will help in achieving the target of eliminating viral hepatitis as a public health threat.