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      Hepatitis C virus spread from HIV-positive to HIV-negative men who have sex with men

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          Abstract

          The aim of this study was to evaluate the potential transmission of HCV strains between HIV-positive men who have sex with men (MSM) and HIV-negative MSM. Since 2000, an ongoing epidemic of HCV infections is observed among HIV-positive MSM in high-income countries. However, HCV infections in HIV-negative MSM are investigated to a lesser extent due to the lack of follow-up in this population and only limited information is available on the risk of HCV transmission between HIV-positive MSM and HIV-negative MSM. We enrolled 49 MSM of which 43 were HIV-positive and 6 HIV-negative, including 4 being enrolled or waiting for enrolment in a preexposure prophylaxis (PrEP) program. All patients were diagnosed with acute HCV infection at the Infectious Disease Unit at the Hospices Civils de Lyon from 2014 to 2016. Risk factors for HCV infection were similar in both groups and included IV or nasal drug use, and rough sex practices. Typing and phylogenetic cluster analysis of HCV variants were performed by NS5B sequencing. Several clusters of infections were identified (genotype 1a: 3 clusters and 1 pair; genotype 4d: 1 cluster and 2 pairs), suggesting that several transmission events occurred within the study population. Every HCV strain identified in HIV-negative MSM was included in a cluster with HIV-positive MSM. Chronological analysis of contagiousness suggested the transmission of HCV from HIV-positive to HIV-negative patients. We conclude that recommendations for HCV surveillance should not be confined to HIV-positive MSM but should be extended to HIV-negative MSM with similar risk factors.

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          Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours.

          To characterize the mode of hepatitis C virus (HCV) transmission in a recent epidemic of acute HCV in HIV-infected individuals using linked molecular and clinical epidemiological studies. Individuals diagnosed with acute HCV between 1999 and 2005 at three urban HIV units in the UK were enrolled into a phylogenetic and case-control study. Phylogenetic trees were constructed from the amplified sequences of the E1/E2 region of the HCV genome and were used to compare cases with unrelated sequences. A questionnaire-based, case-control study using matched controls recruited from each HIV unit identified putative transmission factors. One hundred and eleven HIV-positive men who have sex with men with acute HCV (genotype 1: 84%) were enrolled. Phylogenetic analysis of 93 E1/E2 sequences revealed seven monophyletic clusters signifying multiple independent HCV lineages co-circulating in the HIV-positive population. Permucosal rather than percutaneous transmission factors were associated with case/control status. Cases (n = 60) had more sexual partners, increased levels of high-risk sexual behaviour and were more likely to have shared drugs via a nasal or anal route in the preceding year in comparison with controls (n = 130). Sex in a group of more than two people was the strongest predictor of case/control status; odds ratios associated with participation in two or at least three types of high-risk sexual behaviour in a group were 9.16 (95% confidence interval, 3.51-23.90) and 23.50 (95% confidence interval, 9.47-58.33), respectively. The identified co-circulating HCV lineages belong to different subtypes and genotypes, implying that rather than viral change, the epidemic is due to permucosal transmission factors that should be the focus of public health interventions.
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            Gut Mucosal Barrier Dysfunction, Microbial Dysbiosis, and Their Role in HIV-1 Disease Progression.

            Distinct pathological events occur within the gastrointestinal (GI) tract of Asian macaques with progressive simian immunodeficiency virus (SIV) infection and humans with human immunodeficiency virus type 1 (HIV-1) infection that are critical in shaping disease course. These events include depletion and functional alteration of GI-resident CD4(+) T cells, loss of antigen-presenting cells, loss of innate lymphocytes, and possible alterations to the composition of the gut microbiota. These contribute to structural damage to the GI tract and systemic translocation of GI tract microbial products. These translocated microbial products directly stimulate the immune system, and there is now overwhelming evidence that this drives chronic immune activation in HIV-1 and SIV infection. While combined antiretroviral therapy (cART) in HIV-1-infected subjects generally allows for immune reconstitution in peripheral blood, reconstitution of the GI tract occurs at a much slower pace, and both immunological and structural abnormalities persist in the GI tract. Importantly, studies of large cohorts of individuals have linked suboptimal GI reconstitution to residual inflammation and heightened morbidities in HIV-1-infected cART recipients. As a result, current era treatments aimed at augmenting restoration of the GI tract hold promise in returning cART recipients to full health.
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              Incidence of sexually transmitted hepatitis C virus infection in HIV-positive men who have sex with men.

              The epidemiology of the incidence of sexually transmitted hepatitis C virus (HCV) infection in HIV-positive men who have sex with men (MSM) is only partially understood. In the presence of HIV, HCV infection is more likely to become chronic and liver fibrosis progression is accelerated.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: Writing – original draft
                Role: ConceptualizationRole: ResourcesRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Resources
                Role: Resources
                Role: Resources
                Role: Formal analysisRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 January 2018
                2018
                : 13
                : 1
                : e0190340
                Affiliations
                [1 ] Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
                [2 ] Centre International de Recherche en Infectiologie (CIRI) (Inserm U1111, CNRS UMR 5308), Lyon, France
                [3 ] University of Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
                [4 ] Service des Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
                [5 ] INSERM U1052, Cancer Research Center of Lyon (CRCL), UMR_S1052, Lyon, France
                [6 ] European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden
                [7 ] Centre for Clinical Research, Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
                Centre de recherche du CHUM, CANADA
                Author notes

                Competing Interests: The authors have read the journal's policy and the authors of this manuscript have the following competing interests: Caroline Charre has received travel expenses to conferences from Merck. Laurent Cotte has received research grants from Merck and ViiV Healthacare, travel expenses and registrations to conferences from Abbvie pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck and ViiV Healthcare and fees for interventions from Abbvie pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck and ViiV Healthcare. Joseph Koffi has received fees for interventions from Gilead Sciences. Christophe Ramière has received travel expenses and registrations to conferences from Roche Pharmaceuticals and Merck. None of this funding was in relation with the presented study. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                http://orcid.org/0000-0002-1981-7155
                Article
                PONE-D-17-28864
                10.1371/journal.pone.0190340
                5749770
                29293630
                3c47daea-84e8-4120-acbb-2328f6f5d796
                © 2018 Charre et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 August 2017
                : 13 December 2017
                Page count
                Figures: 2, Tables: 2, Pages: 10
                Funding
                The author(s) received no specific funding for this work.
                Categories
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                Custom metadata
                All HCV NS5B sequences isolated in MSM and non-MSM patients reported in this study were submitted to the GenBank database and have received GenBank accession numbers KY928311-KY928401.

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