Development and validation of the HCV-MOSAIC risk score to assist testing for acute hepatitis C virus (HCV) infection in HIV-infected men who have sex with men (MSM)

© 2017, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Current guidelines recommend hepatitis C virus (HCV) testing for HIV-infected men who have sex with men (MSM) with ongoing risk behaviour, without specifying the type of risk behaviour. We developed and validated the HCV-MOSAIC risk score to assist HCV testing in HIV-infected MSM. The risk score consisted of six self-reported risk factors identified using multivariable logistic regression using data from the Dutch MOSAIC study (n = 213, 2009–2013). Area under the ROC curve (AUC), sensitivity, specificity, post-test-probability-of-disease and diagnostic gain were calculated. The risk score was validated in case–control studies from Belgium (n = 142, 2010–2013) and the United Kingdom (n = 190, 2003–2005) and in cross-sectional surveys at a Dutch sexually transmitted infections clinic (n = 284, 2007–2009). The AUC was 0.82; sensitivity 78.0% and specificity 78.6%. In the validation studies sensitivity ranged from 73.1% to 100% and specificity from 56.2% to 65.6%. The post-test-probability-of-disease ranged from 5.9% to 20.0% given acute HCV prevalence of 1.7% to 6.4%, yielding a diagnostic gain of 4.2% to 13.6%. The HCV-MOSAIC risk score can successfully identify HIV-infected MSM at risk for acute HCV infection. It could be a promising tool to improve HCV testing strategies in various settings

Risk Factors for Sexual Transmission of Hepatitis C Virus Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: A Case-Control Study

Background. Since 2000, incidence of sexually acquired hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). To date, few case-control and cohort studies evaluating HCV transmission risk factors were conducted in this population, and most of these studies were initially designed to study HIV-related risk behavior and characteristics. Methods. From 2009 onwards, HIV-infected MSM with acute HCV infection and controls (HIV-monoinfected MSM) were prospectively included in the MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study at 5 large HIV outpatient clinics in the Netherlands. Written questionnaires were administered, covering socio-demographics, bloodborne risk factors for HCV infection, sexual behavior, and drug use. Clinical data were acquired through linkage with databases from the Dutch HIV Monitoring Foundation. For this study, determinants of HCV acquisition collected at the inclusion visit were analyzed using logistic regression. Results. Two hundred thirteen HIV-infected MSM (82 MSM with acute HCV infection and 131 MSM without) were included with a median age of 45.7 years (interquartile range [IQR], 41.0-52.2). Receptive unprotected anal intercourse (adjusted odds ratio [aOR], 5.01; 95% confidence interval [CI], 1.63-15.4), sharing sex toys (aOR, 3.62; 95% CI, 1.04-12.5), unprotected fisting (aOR, 2.57; 95% CI, 1.02-6.44), injecting drugs (aOR, 15.62; 95% CI, 1.27-192.6), sharing straws when snorting drugs (aOR, 3.40; 95% CI, 1.39-8.32), lower CD4 cell count (aOR, 1.75 per cubic root; 95% CI, 1.19-2.58), and recent diagnosis of ulcerative sexually transmitted infection (aOR, 4.82; 95% CI, 1.60-14.53) had significant effects on HCV acquisition. Conclusions. In this study, both sexual behavior and biological factors appear to independently increase the risk of HCV acquisition among HIV-infected MSM

Sexually transmitted infections in the Netherlands in 2022

In 2022, the number of people tested at a Sexual Health Centre (SHC) for a sexually transmitted infection (STI) was higher compared to 2021. The percentage with an STI (21 per cent) was higher compared to 2021. Persons who were notified of an STI by a partner and persons with symptoms had an STI most often. SHCs offer free STI testing to people at high risk of acquiring an STI. Since August 2019, SHCs have also provided care to men who have sex with men (MSM) who receive a drug to prevent HIV (Pre-Exposure Prophylaxis, PrEP). This group is tested for STIs every three months (MSM – PrEP pilot). This overview shows how many tests and diagnoses the SHCs have registered per STI. In 2022, there were a total of 164,715 consultations. Chlamydia There were 24,684 chlamydia diagnoses in 2022, an increase of 21 per cent compared to 2021 (20,465). The percentage of women with chlamydia was higher in 2022 than in 2021, rising from 16.2 to 17.9 per cent. The percentages of heterosexual men and MSM with chlamydia fell slightly to 21.2 and 10.9 percent respectively. Among MSM-PrEP pilot participants, this percentage decreased from 10 per cent in 2021 to 9.4 per cent in 2022. Gonorrhoea The number of gonorrhoea diagnoses (10,600) was higher than in 2021 (7,964), an increase of 33 per cent. The percentages of women and heterosexual men with gonorrhoea increased in 2022, after a slight decrease in 2021, to 2.3 and 2.4 per cent respectively. This is the highest percentage among women since 2013. The increase was mainly seen in the second half of 2022. The percentage among MSM rose from 12.4 per cent in 2021 to 12.8 per cent in 2022. Among MSM-PrEP pilot participants, the percentage increased from 9.2 per cent in 2021 to 9.8 per cent in 2022. No antibiotic resistance to the current ‘first choice’ antibiotic for gonorrhoea (ceftriaxone) was reported. Syphilis In 2022, the number of syphilis diagnoses (1,574) was higher than in 2021 (1,398). The percentage of MSM with syphilis was 2.3 per cent in 2022, a slight decrease compared to 2021 (2.6 per cent). Among MSM-PrEP pilot participants, this percentage was stable at 1.7 per cent in 2022. The number of diagnoses among women and heterosexual men remained low in 2022, at 34 for both groups. HIV In 2022, 144 people received an HIV diagnosis, a slight increase compared to 2021 (138). Of these diagnoses, 103 were among MSM and 10 among PrEP pilot participants. The remaining number of diagnoses was 11 for women and 8 for heterosexual men. The number of people with HIV who came to an HIV treatment centre for the first time in 2022 (‘in care’) was 997. This was an increase of 26 per cent compared to 2021 (794). PrEP Among national PrEP pilot participants, 12,195 persons (97 percent MSM) had a first PrEP consultation, of whom 2,413 in 2022. On 31 December 2022, the PrEP pilot programme had an estimated 8,558 participants. In 2022, the percentage of participants with an STI was 18.1 percent. Mpox The first cases of mpox (previously known as monkeypox) in the Netherlands were reported in May 2022. A total of 1,259 mpox infections were reported to RIVM that year, 92 per cent of which were among MSM

Seksueel overdraagbare aandoeningen in Nederland in 2022

In 2022, the number of people tested at a Sexual Health Centre (SHC) for a sexually transmitted infection (STI) was higher compared to 2021. The percentage with an STI (21 per cent) was higher compared to 2021. Persons who were notified of an STI by a partner and persons with symptoms had an STI most often. SHCs offer free STI testing to people at high risk of acquiring an STI. Since August 2019, SHCs have also provided care to men who have sex with men (MSM) who receive a drug to prevent HIV (Pre-Exposure Prophylaxis, PrEP). This group is tested for STIs every three months (MSM – PrEP pilot). This overview shows how many tests and diagnoses the SHCs have registered per STI. In 2022, there were a total of 164,715 consultations. Chlamydia There were 24,684 chlamydia diagnoses in 2022, an increase of 21 per cent compared to 2021 (20,465). The percentage of women with chlamydia was higher in 2022 than in 2021, rising from 16.2 to 17.9 per cent. The percentages of heterosexual men and MSM with chlamydia fell slightly to 21.2 and 10.9 percent respectively. Among MSM-PrEP pilot participants, this percentage decreased from 10 per cent in 2021 to 9.4 per cent in 2022. Gonorrhoea The number of gonorrhoea diagnoses (10,600) was higher than in 2021 (7,964), an increase of 33 per cent. The percentages of women and heterosexual men with gonorrhoea increased in 2022, after a slight decrease in 2021, to 2.3 and 2.4 per cent respectively. This is the highest percentage among women since 2013. The increase was mainly seen in the second half of 2022. The percentage among MSM rose from 12.4 per cent in 2021 to 12.8 per cent in 2022. Among MSM-PrEP pilot participants, the percentage increased from 9.2 per cent in 2021 to 9.8 per cent in 2022. No antibiotic resistance to the current ‘first choice’ antibiotic for gonorrhoea (ceftriaxone) was reported. Syphilis In 2022, the number of syphilis diagnoses (1,574) was higher than in 2021 (1,398). The percentage of MSM with syphilis was 2.3 per cent in 2022, a slight decrease compared to 2021 (2.6 per cent). Among MSM-PrEP pilot participants, this percentage was stable at 1.7 per cent in 2022. The number of diagnoses among women and heterosexual men remained low in 2022, at 34 for both groups. HIV In 2022, 144 people received an HIV diagnosis, a slight increase compared to 2021 (138). Of these diagnoses, 103 were among MSM and 10 among PrEP pilot participants. The remaining number of diagnoses was 11 for women and 8 for heterosexual men. The number of people with HIV who came to an HIV treatment centre for the first time in 2022 (‘in care’) was 997. This was an increase of 26 per cent compared to 2021 (794). PrEP Among national PrEP pilot participants, 12,195 persons (97 percent MSM) had a first PrEP consultation, of whom 2,413 in 2022. On 31 December 2022, the PrEP pilot programme had an estimated 8,558 participants. In 2022, the percentage of participants with an STI was 18.1 percent. Mpox The first cases of mpox (previously known as monkeypox) in the Netherlands were reported in May 2022. A total of 1,259 mpox infections were reported to RIVM that year, 92 per cent of which were among MSM.In 2022 hebben meer mensen zich bij een Centrum voor Seksuele Gezondheid (CSG(Centrum Seksuele Gezondheid)) laten testen op seksueel overdraagbare aandoeningen (soa(seksueel overdraagbare aandoening )) dan in 2021. Het percentage dat een soa had (21 procent) was hoger dan in 2021. Mensen die via een partner een melding ontvingen voor een soa of zelf klachten hadden, hadden het vaakst een soa. Bij CSG’s kunnen mensen met een grotere kans op soa, zich gratis laten testen. Sinds augustus 2019 bieden deze centra ook zorg aan mannen die seks hebben met mannen (MSM(mannen die seks hebben met mannen)) die een geneesmiddel krijgen dat hiv(humaan immunodeficientievirus) voorkomt (Pre-Expositie Profylaxe, PrEP(pre-expositie profylaxisis)). Deze groep wordt elke drie maanden getest op soa (MSM-PrEP pilot). In dit overzicht staat per soa aangegeven hoeveel testen en diagnoses er bij de CSG’s zijn geregistreerd. In 2022 waren er in totaal 164.715 consulten. Chlamydia In 2022 waren er 24.684 chlamydia-diagnoses, een stijging van 21 procent in vergelijking met 2021 (20.465). Het percentage vrouwen met chlamydia was in 2022 hoger dan in 2021: het steeg van 16,2 naar 17,9 procent. De percentages heteroseksuele mannen en MSM met chlamydia zijn licht gedaald naar respectievelijk 21,2 en 10,9 procent. Onder MSM-PrEP pilot is dit percentage gedaald van 10 procent in 2021 naar 9,4 procent in 2022. Gonorroe Het aantal diagnoses gonorroe (10.600) was hoger dan in 2021 (7.964), een stijging van 33 procent. De percentages vrouwen en heteroseksuele mannen met gonorroe zijn in 2022, na een lichte daling in 2021, sterk toegenomen naar respectievelijk 2,3 en 2,4 procent. Dit is het hoogste percentage onder vrouwen sinds 2013; de toename was vooral in de tweede helft van 2022 te zien. Het percentage onder MSM steeg van 12,4 procent in 2021 naar 12,8 procent in 2022. Onder MSM-PrEP pilot steeg het percentage van 9,2 procent in 2021 naar 9,8 procent in 2022. Er is geen antibioticaresistentie tegen het huidige ‘eerste keus’ antibioticum voor gonorroe (ceftriaxon) gemeld. Syfilis In 2022 was het aantal syfilis-diagnoses (1.574) hoger dan in 2021 (1.398). Het percentage MSM met syfilis was 2,3 procent in 2022, een lichte daling in vergelijking met 2021 (2,6 procent). Onder MSM-PrEP pilot was dit percentage stabiel op 1,7 procent in 2022. Het aantal diagnoses onder vrouwen en heteroseksuele mannen bleef in 2022 laag, voor beide groepen was dit 34. Hiv(humaan immunodeficientievirus) In 2022 kregen 144 personen een hiv-diagnose, iets meer dan in 2021 (138). Hiervan waren 103 diagnoses bij MSM en 10 diagnoses bij deelnemers aan de PrEP pilot. Het aantal diagnoses bij vrouwen was 11 en bij heteroseksuele mannen 8. Het aantal mensen met hiv dat in 2022 voor het eerst naar een hiv-behandelcentra kwam (‘in zorg’) was 997. Dat was 26 procent meer dan in 2021 (794). PrEP n de nationale PrEP pilot hebben 12.195 personen (97 procent MSM) een eerste PrEP-consult gehad, van wie 2.413 in 2022. Op 31 december 2022 had het PrEP pilot-programma naar schatting 8.558 deelnemers. Het percentage deelnemers met een soa was in 2022 18,1 procent. Mpox In mei 2022 zijn in Nederland de eerste gevallen van mpox (eerder bekend als apenpokken) gemeld. In totaal zijn dat jaar bij het RIVM 1.259 mpox-infecties gemeld, waarvan 92 procent onder MSM