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Six-question risk score can identify HIV-positive gay men needing testing for acute hepatitis C

By David Rowlands, Jun 7 2017 02:32PM

Six questions can identify HIV-positive gay men who are at elevated risk of having acute (recent) hepatitis C infection and who would benefit from further testing, according to a paper published in Eurosurveillance last week. The risk score was based on data from a Dutch cohort and has been validated with separate datasets from Belgium, the Netherlands and England.


Better targeted testing of hepatitis C for gay men living with HIV could reduce the number of tests done, lowering costs and facilitating implementation in settings such as sexual health clinics. There is a lack of recommendations on how to target hepatitis C testing.


Guidelines from the European AIDS Treatment Network recommend six-monthly testing of liver function and annual testing for antibodies, for HIV-positive gay men “at risk for contracting acute hepatitis C infection” – but don’t specify how clinicians should identify individuals who might be at risk.


Guidelines from the American Association for the Study of Liver Disease and the Infectious Diseases Society of America recommend that all HIV-positive gay men who have unprotected sex should have annual hepatitis C screening.


The six questions in the risk score concern self-reported behaviours:


Condomless receptive anal intercourse in the past six months (score 1.1)

Sharing of sex toys in the past six months (score 1.2)

Fisting without gloves in the past six months (score 0.9)

Injecting drug use in the past 12 months (score 1.4)

Sharing of straws to snort drugs in the past 12 months (score 1.0)

An ulcerative sexually transmitted infection in the past 12 months (score 1.4)


A man scoring a total of 2.0 or more would be recommended to be tested for acute hepatitis C.


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Source of information aidsmap.com

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