San Francisco HIV/HCV Coinfection Community Forum on June 7

		SUMMARY: On Monday, June 7, the San Francisco Hepatitis C Task Force and the city's HIV Health Services Planning Council will hold a community forum to discuss hepatitis C virus (HCV) coinfection in HIV positive gay and bisexual men. The forum will take place from 6:00-8:00 pm at the Eureka Valley Recreation Center, 100 Collingwood Street, San Francisco.

About one-third of people with HIV are estimated to be coinfected with HCV, and hepatitis C is now a leading cause of death for in HIV positive people.

The issue of HIV/HCV coinfection among men who have sex with men has come on the radar only in the last decade. Clinicians first began reporting outbreaks of apparently sexually transmitted acute hepatitis C among gay men in the early 2000s in the U.K., followed by large cities in Europe, Australia, and the U.S.

Studies have produced mixed findings about how HCV is spread among this group, but most find transmission is linked to sex practices including fisting, sex while high, sex with multiple partners and in group sex environments, and presence of other sexually transmitted diseases. Studies disagree about whether unprotected anal intercourse is a risk factor for HCV transmission, but most experts believe transmission occurs via small amounts of HCV-infected blood, not semen.

HIV/HCV coinfection is a concern because some studies indicate that liver disease progresses more rapidly in HIV positive people and coinfected individuals also do not respond as well to interferon-based therapy for hepatitis C.

Experts recommend that HIV positive people should be tested for HCV, but some providers remain reluctant to do so for patients who do not have a history of injection drug use (as shared needles are the most common HCV transmission route in the U.S.). The New York State Department of Health AIDS Institute recently revised its guidelines to recommend annual HCV testing for HIV positive people who use injection drugs, have more than 1 sexual partner, or have are men who have unprotected sex with other men.

Participants at Monday's forum will include Brad Hare, MD, medical director of the UCSF Positive Health Program at San Francisco General Hospital; Val Robb, RN, who runs the Positive Health Program's Hepatitis C Project; San Francisco District 8 supervisor Bevan Dufty; and a panel of coinfected individuals.

6/4/10

Sources

San Francisco Hepatitis C Task Force.

C Laird. Forum on HIV/hep C co-infection. Bay Area Reporter. June 3, 2010.

New York State Department of Health AIDS Institute. Clinical Guidelines Update: Hepatitis C Virus in HIV-Infected Patients. May 2010.