Gaining Greater Insight into HCV Emergence in HIV-Infected Men Who Have Sex with Men: The HEPAIG Study

OBJECTIVES: The HEPAIG study was conducted to better understand Hepatitis C virus (HCV) transmission among human immuno-deficiency (HIV)-infected men who have sex with men (MSM) and assess incidence of HCV infection among this population in France. METHODS AND RESULTS: Acute HCV infection defined by anti-HCV or HCV ribonucleic acid (RNA) positivity within one year of documented anti-HCV negativity was notified among HIV-infected MSM followed up in HIV/AIDS clinics from a nationwide sampling frame. HIV and HCV infection characteristics, HCV potential exposures and sexual behaviour were collected by the physicians and via self-administered questionnaires. Phylogenetic analysis of the HCV-NS5B region was conducted. HCV incidence was 48/10 000 [95% Confidence Interval (CI):43-54] and 36/10 000 [95% CI: 30-42] in 2006 and 2007, respectively. Among the 80 men enrolled (median age: 40 years), 55% were HIV-diagnosed before 2000, 56% had at least one sexually transmitted infection in the year before HCV diagnosis; 55% were HCV-infected with genotype 4 (15 men in one 4d-cluster), 32.5% with genotype 1 (three 1a-clusters); five men were HCV re-infected; in the six-month preceding HCV diagnosis, 92% reported having casual sexual partners sought online (75.5%) and at sex venues (79%), unprotected anal sex (90%) and fisting (65%); using recreational drugs (62%) and bleeding during sex (55%). CONCLUSIONS: This study emphasizes the role of multiple unprotected sexual practices and recreational drugs use during sex in the HCV emergence in HIV-infected MSM. It becomes essential to adapt prevention strategies and inform HIV-infected MSM with recent acute HCV infection on risk of re-infection and on risk-reduction strategies

Acute hepatitis C: Current status and remaining challenges

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Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control Study

OBJECTIVES: To identify risk factors for hepatitis C among HIV-positive men who have sex with men (MSM), focusing on potential sexual, nosocomial, and other non-sexual determinants. BACKGROUND: Outbreaks of hepatitis C virus (HCV) infections among HIV-positive MSM have been reported by clinicians in post-industrialized countries since 2000. The sexual acquisition of HCV by gay men who are HIV positive is not, however, fully understood. METHODS: Between 2006 and 2008, a case-control study was embedded into a behavioural survey of MSM in Germany. Cases were HIV-positive and acutely HCV-co-infected, with no history of injection drug use. HIV-positive MSM without known HCV infection, matched for age group, served as controls. The HCV-serostatus of controls was assessed by serological testing of dried blood specimens. Univariable and multivariable regression analyses were used to identify factors independently associated with HCV-co-infection. RESULTS: 34 cases and 67 controls were included. Sex-associated rectal bleeding, receptive fisting and snorting cocaine/amphetamines, combined with group sex, were independently associated with case status. Among cases, surgical interventions overlapped with sex-associated rectal bleeding. CONCLUSIONS: Sexual practices leading to rectal bleeding, and snorting drugs in settings of increased HCV-prevalence are risk factors for acute hepatitis C. We suggest that sharing snorting equipment as well as sharing sexual partners might be modes of sexual transmission. Condoms and gloves may not provide adequate protection if they are contaminated with blood. Public health interventions for HIV-positive gay men should address the role of blood in sexual risk behaviour. Further research is needed into the interplay of proctosurgery and sex-associated rectal bleeding

Evolution of Photoluminescence across Dimensionality in Lanthanide Silicates

The dehydratation process of layered lanthanide silicates K3[LnSi3O8(OH)2], Ln = Y, Eu, Tb, and Er, and the structural characterization of the obtained small-pore framework K3LnSi3O9, Ln = Y, Eu, Tb, and Er solids, named AV-23, have been reported. The structure of AV-23 has been solved by single-crystal X-ray diffraction (XRD) methods and further characterized by chemical analysis, thermogravimetry, scanning electron microscopy, and 29Si MAS NMR. The photoluminescence (PL), radiance, and lifetime values of AV-23 have been studied and compared with those of AV-22. Both materials have a similar chemical makeup and structures sharing analogous building blocks, hence providing a unique opportunity for rationalizing the evolution of the PL properties of lanthanide silicates across dimensionality. Although Tb-AV-23 contains a single crystallographic Tb3+ site, PL spectroscopy indicates the presence of Ln3+ centers in regular framework positions and in defect regions. PL evidence suggests that Eu-AV-23 contains a third type of Ln3+ environment, namely, Eu3+ ions replacing K+ ions in the micropores. The radiance values of the Tb-AV-22 and Tb-AV-23 samples are of the same order of magnitude as those of standard Tb3+ green phosphors. For the samples K3(Y1-aEraSi3O9), a = 0.005−1, efficient emission and larger 4I13/2 lifetimes (ca. 7 ms) are detected for low Er3+ content, indicating that the Er3+−Er3+ interactions become significant as the Er3+ content increases

Evolution of Photoluminescence across Dimensionality in Lanthanide Silicates

The dehydratation process of layered lanthanide silicates K3[LnSi3O8(OH)2], Ln = Y, Eu, Tb, and Er, and the structural characterization of the obtained small-pore framework K3LnSi3O9, Ln = Y, Eu, Tb, and Er solids, named AV-23, have been reported. The structure of AV-23 has been solved by single-crystal X-ray diffraction (XRD) methods and further characterized by chemical analysis, thermogravimetry, scanning electron microscopy, and 29Si MAS NMR. The photoluminescence (PL), radiance, and lifetime values of AV-23 have been studied and compared with those of AV-22. Both materials have a similar chemical makeup and structures sharing analogous building blocks, hence providing a unique opportunity for rationalizing the evolution of the PL properties of lanthanide silicates across dimensionality. Although Tb-AV-23 contains a single crystallographic Tb3+ site, PL spectroscopy indicates the presence of Ln3+ centers in regular framework positions and in defect regions. PL evidence suggests that Eu-AV-23 contains a third type of Ln3+ environment, namely, Eu3+ ions replacing K+ ions in the micropores. The radiance values of the Tb-AV-22 and Tb-AV-23 samples are of the same order of magnitude as those of standard Tb3+ green phosphors. For the samples K3(Y1-aEraSi3O9), a = 0.005−1, efficient emission and larger 4I13/2 lifetimes (ca. 7 ms) are detected for low Er3+ content, indicating that the Er3+−Er3+ interactions become significant as the Er3+ content increases

Tubulointerstitial nephritis and Fanconi syndrome in primary biliary cirrhosis

Primary biliary cirrhosis is a chronic cholestatic liver disease of unknown cause that predominantly affects middle-aged women. Distal tubular acidosis is the main renal complication of primary biliary cirrhosis. Tubulointerstitial nephritis and Fanconi syndrome have been reported more rarely. We report on 2 patients with primary biliary cirrhosis who presented with tubulointerstitial nephritis and Fanconi syndrome and review similar cases published previously. Serum from 1 patient exerted an inhibitory effect on pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase, 2 mitochondrial enzymes that are the main targets of antimitochondrial antibodies in primary biliary cirrhosis. Antimitochondrial antibodies may have a role in the genesis of tubulointerstitial nephritis and Fanconi syndrome, 2 typical renal features of mitochondrial cytopathies. Tubulointerstitial nephritis and Fanconi syndrome have to be added to the spectrum of renal diseases associated with primary biliary cirrhosis