International hepatitis C virus transmission dynamics among men who have sex with men (MSM)

Researchers from Amsterdam UMC found evidence for substantial international transmission of hepatitis C virus (HCV) among men who have sex with men (MSM). European MSM were more likely to be linked to each other than to non-European MSM. No transmission of highly resistant viruses was observed. These findings support an international approach to achieve HCV elimination among MSM. The results of this study were published in The Lancet Microbe.

Hepatitis C virus (HCV) is an inflammation of the liver caused by the HCV. Approximately 58 million people worldwide are infected with HCV. An estimated 290,000 people die each year worldwide from chronic HCV infection¹. Globally, men who have sex with men (MSM) with HIV and MSM using preexposure prophylaxis (PrEP) to prevent HIV are at increased risk of acquiring HCV. For this reason, it is important to understand HCV transmission among MSM.

Therefore, researchers from Amsterdam UMC set to work in a multicenter international clinical trial, called the REACT study. Within the REACT study viruses from MSM with a recently acquired HCV infection were examined. Sequences obtained in the same country clustered frequently, suggestive of local HCV transmission, but in 36% of recent clusters the researchers showed evidence of international transmission. European MSM were more likely to be in a cluster than non-European MSM. A possible explanation could be that cross border traveling within Europa is more likely then intercontinental travel between Australia, the United States of America and Europe.

HCV transmission continues among MSM both locally and in international, mainly European, transmission networks. In order to achieve and maintain micro-elimination (elimination of HCV in certain subpopulations) in this population, local programs within the MSM community aimed at increasing awareness about HCV, promoting preventive measures and increased testing and treatment uptake are essential. The results from this study imply that international coordination and surveillance may be required to eliminate HCV in this subpopulation.

NomoreC

As mentioned before, HCV elimination among MSM
is unlikely to be feasible without effective local interventions focused on the behavior of MSM. Therefore, Tamara Prinsenberg and team developed a multilevel intervention to reduce HCV transmission among MSM in Amsterdam, the NomoreC campaign, an Amsterdam UMC initiated program. The intervention includes a toolbox to facilitate risk reduction among MSM and support health care professionals in risk reduction counselling. The results are promising: the toolbox has been well received by MSM, increased awareness of HCV risks and has facilitated preventive behaviours and risk-reduction communication with peers. Also professionals mentioned the toolbox being useful for discussions about HCV risk and risk reduction strategies with
their clients.

PhD defense ceremonies

On the 5^th of July Tamara Prinsenberg’s PhD defense ceremony will take placet, where she will share more about her work titled ‘Micro-elimination of hepatitis C virus among men who have sex with men |Innovative testing and prevention strategies in the Netherlands’.

Jelle Koopsen successfully defended his thesis titled ‘Understanding hepatitis C virus and SARS-CoV-2 transmission in elimination and outbreak settings’ on the 4^th of April 2023.

Researchers involved at Amsterdam UMC:

Jelle Koopsen, Postdoctoral Researcher at Amsterdam UMC / GGD Amsterdam

Tamara Prinsenberg, PhD candidate at Amsterdam UMC/ GGD Amsterdam

Sjoerd Rebers, Research Technician at Amsterdam UMC

Janke Schinkel, Head of Clinical Microbiology Laboratories at the Department of Medical Microbiology, Amsterdam UMC

Maria Prins, professor of Public Health and Epidemiology of Infectious Diseases at Amsterdam UMC

Marc van der Valk, professor of Medicine at Amsterdam UMC/ Stichting hiv monitoring (SHM)

For more information, contact Jelle Koopsen or Tamara Prinsenberg or read the scientific publication here.

Funding:

The REACT study was an NIH funded trial coordinated by The Kirby Institute in Sydney (NIDA division, grant number R01DA040506). Sequencing of Dutch viral isolates was partially funded by the Dr. C.J. Vaillant Fonds.

Nomore C was established in 2017 at the initiative of Amsterdam UMC, GGD Amsterdam, Soa Aids Nederland and AIGHD.

Text: Esmée Vesseur

References:

¹ Hepatitis C. https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c