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Unselected GUM clinic screening for HCV in MSM is not currently justified
Sexual acquisition of hepatitis C virus (HCV) in men who have sex with men (MSM) is increasingly being reported and associated with unprotected anal sex, fisting and, in particular, known HIV infection. Researchers in London evaluated unselected HCV screening in MSM presenting to the GUM clinic between 1 January and 30 June 2007. Of 3365 MSM attending for sexually transmitted infection (STI) screening, 69% underwent HCV antibody testing. Fifteen patients tested anti-HCV positive (prevalence 0.65%, 95% CI 0.36% to 1.1%). Three of these patients were known to be HIV infected at baseline; the others tested HIV antibody negative at the time of screening. All except three patients had documented HCV risk factors including intravenous drug use and drug insufflation. The prevalence of HCV in HIV-negative MSM or those of unknown HIV status was 0.61% (95% CI 0.31% to 1.1.%)—equivalent to the general UK population. Unselected GUM screening in MSM would cost £84 750/quality-adjusted life year (QALY). Testing only 10% …