Purpose of review: Increasing evidence has emerged for permucosal transmission of hepatitis C amongst HIV-infected MSM.
Recent findings: A rising incidence of acute hepatitis C virus (HCV) in HIV-infected MSM has been observed since 2000 in Europe, Australia, USA and Asia. Transmission appears to occur through the permucosal rather than the more usual parenteral route. Although often multifactorial, permucosal risk factors can be classified as behavioural (sexual practices and mucosally administered drugs) and biological (HIV and sexually transmitted infections). This review will describe the epidemiology of HCV infection in this cohort. Current and future treatment strategies will also be outlined in the context of novel, orally bioavailable, directly acting antiviral therapies.
Summary: An improved understanding of HCV epidemiology will allow implementation of more effective public health interventions to limit onward transmission of HCV.