SNAHC pilot - Surveillance of Newly Acquired Hepatitis C in men who have sex with men
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SNAHC pilot- Surveillance of Newly Acquired Hepatitis C in men who have sex with men Hepatitis C (HCV) is a blood borne virus. Infection is commonly asymptomatic. The majority of infected individuals cannot clear HCV, and infection persists for many years leading to chronic liver disease, and in some cases hepatocellular carcinoma . In the UK, the main risk factor for HCV is injecting drug use (IDU). (see hepatitis C link below for general information). However, there has been an increase in HCV among men who have sex with men (MSM) in the United Kingdom. |
Information about SNAHC
In recent years there have been an increasing number of reports of newly acquired HCV infections among HIV positive men who have sex with men (MSM) in London as well as several other major cities in Europe. HCV transmission in MSM is thought to occur primarily through sexual contact.
A 2006 joint HPA, British Association for Sexual Health and HIV (BASHH), and British HIV Association (BHIVA) survey of genito-urinary medicine (GUM) and HIV clinics across London and the Southeast Region found a total of 389 cases of newly acquired HCV in HIV+MSM between 2002 and June 2006. Incidence estimates from these data suggested a statistically significant, 20% year-on-year increase in incidence in HIV positive MSM over the study period. Only six cases were reported in MSM with negative or unknown HIV status (although less frequent routine HCV testing in MSM not known to be HIV positive in may have resulted in fewer cases being detected).
Dual HIV/HCV infection has significant impact on morbidity and mortality. Although treatments and clinical management are improving, large gaps in our knowledge remain with regards to its epidemiology (such as how common is the infection among MSM) and risk factors associated with infection among MSM.
In response, the HPA is piloting the enhanced surveillance of newly acquired hepatitis C infections (SNAHC) among MSM attending HIV and GUM clinics in London, Brighton Hastings, Eastbourne, Oxford and Southampton. The SNAHC pilot is endorsed by BHIVA and BASHH.
The key objectives of the SNAHC pilot are to:
- To assess the burden of newly acquired HCV in MSM attending GUM/HIV clinics in London and the South East
- To monitor trends in newly acquired HCV in MSM over time and geographical areas
- To monitor behavioural risk factors for acquisition of HCV
- To inform public health interventions and prevention initiatives
Surveillance definitions of a newly acquired HCV case for MSM
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A newly acquired hepatitis C case in MSM will be defined as::
HCV antibody positive and had a documented negative HCV antibody within the previous 36 months Probable case HCV RNA positive AND HCV antibody negative or equivocal |
The pilot will be evaluated in late 2008 to inform the roll-out across England. For more information on the project:
SNAHC_background.pdf (PDF, 125 KB)
SNAHC_pilot_protocol.pdf (PDF, 277 KB)
Retro_case_reporting_form.pdf (PDF, 113 KB)
Related information
BHIVA guidelines for HIV and Hepatitis C coinfection: http://www.bhiva.org/cms1191560.asp
General information on hepatitis C:
Project contact details
Dr. Murad Ruf
Specialist Registrar in Public Health
Health Protection Agency
Centre for Infections
Tel: +44 (0)20 8327 7145
Email: murad.ruf@hpa.org.uk
Dr Sandra Cohuet
Fellow of European Programme for Intervention Epidemiology Training
Health Protection Agency
London Regional Epidemiology Unit
Tel: +44 (0)20 7759 2812
Email: sandra.cohuet@hpa.org.uk
Last reviewed: 28 February 2008