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P5.022 Earlier HCV Diagnosis by the Introduction of Routine HCV Testing For HIV Positive MSM and MSM Opting Out For HIV in a Large STI Outpatient Clinic
  1. M S van Rooijen1,
  2. T Heijman1,
  3. N H N de Vrieze1,
  4. A Urbanus1,
  5. A G C L Speksnijder1,
  6. P van Leeuwen1,
  7. H J C de Vries1,2,
  8. M Prins1,3
  1. 1Public Health Service, Cluster of Infectious diseases, Amsterdam, The Netherlands
  2. 2Academic Medical Center, Department of Dermatology, Amsterdam, The Netherlands
  3. 3Academic Medical Center, Department of Clinical Virology, Amsterdam, The Netherlands

Abstract

Background In October 2007 at a large STI outpatient clinic (SOC), anti-HCV screening was introduced for HIV unaware MSM opting-out for HIV testing (MOH) and HIV-positive MSM. We evaluated whether this screening resulted in additional and earlier HCV diagnosis in HIV-positive MSM also attending HIV treatment centres (HTC).

Methods At first visit, MOH and HIV-positive MSM visiting the SOC in Amsterdam were screened for anti-HCV. During follow-up visits, only those previously HCV negative were tested. Retrospectively, date of new HCV diagnosis at SOC was compared with HCV data provided by HTC.

Results The anti-HCV prevalence at first screening was 0.7% (3/450) among MOH and 6.4% (112/1,742) among HIV-positive MSM of whom 30% (34/112) did not report a history of HCV. In 133 follow-up visits to MOH 0 and in 3,286 follow-up visits to HIV-positive MSM 52 HCV seroconversions were found. These 52 seroconverters and the 34 MSM anti-HCV positive at first screening, excluding 13 MSM who were detected at HTC before SOC started anti-HCV screening, were compared with HTC data. Additional data from HTC was available for 56/73 clients. 29/56 (52%) were first diagnosed at SOC: 7 were concurrently diagnosed with HIV and not in care at HTC; 11 were scheduled for a routine visit at HTC within 1 month; 3 within 3 months; 3 within a year and all 17 were tested and diagnosed with HCV at HTC because of elevated ALT values; 3 HCV diagnoses would have been missed because ALT was low or considered non-HCV related; 2 missed ALT data.

Conclusions The introduction of routine HCV-antibody screening in SOC resulted in additional and earlier diagnoses of HCV in MSM. Testing should focus on HIV-positive MSM especially those newly diagnosed with HIV. Since anti-HCV testing does not identify acute infections, additional testing policies should be evaluated at SOC.

  • HCV
  • MSM
  • STI clinic

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