Acute hepatitis C virus infection among men who have sex with men Epidemiology, diagnosis, treatment, and outcomes

This thesis focused on acute hepatitis C virus (HCV) infections among men who have sex with men (MSM). The overall aim was to gain more insight into the interplay between human immunodeficiency virus (HIV) and HCV infection among MSM. In the first part of this thesis, epidemiology and diagnosis of acute HCV infection among MSM were illustrated. In this part, a risk score was developed and validated that was successful in identifying HIV-infected MSM at risk for acute HCV infection. Furthermore, the HCV prevalence over time among HIV-negative MSM was evaluated. The second part focused on HCV treatment and resistance to treatment and included studies on HCV treatment uptake and viral phylogenetic analysis of resistance-associated substitutions. In the third and last part of this thesis, outcomes of acute HCV infection among HIV-positive MSM were studied, including the spontaneous clearance rate, the prevalence of liver fibrosis, and risk factors for HCV reinfection.