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Volume 17, Number 8—August 2011

Letter

Acute Hepatitis C Outbreak among HIV-infected Men, Madrid, Spain

Ana Montoya-FerrerComments to Author , Daniel Seth Fierer, Beatriz Alvarez-Alvarez, Miguel de Gorgolas, and Manuel L. Fernandez-Guerrero
Author affiliations: Author affiliations: Universidad Autonoma de Madrid, Madrid, Spain (A. Montoya-Ferrer, B. Alvarez-Alvarez, M. de Gorgolas, M.L. Fernandez-Guerrer); Mount Sinai School of Medicine, New York, New York, USA (D.S. Fierer)

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Table

Description of 4 HIV-infected men with HCV infection, Madrid, Spain, 2010*

Characteristic Patient 1 Patient 2 Patient 3 Patient 4
Age, y 31 41 39 39
Country of origin Italy Ecuador Spain Spain
Date of HIV diagnosis 2006 Jun 2000 Jul 1998 2001
Year ART initiated 2008 2000 2006 2006
Prior negative HCV test 2006 None† None† 2008
Date AHC diagnosed May 2010 May 2010 May 2010 May 2010
CD4 count, cells/μL 562 327 787 750
HIV viral load Undetectable Undetectable Undetectable Undetectable
Symptoms at diagnosis No Mild asthenia only No No
ALT/AST levels at AHC diagnosis, U/L 564/331 304/216 222/114 261/125
HCV genotype 4 4 1a Indeterminate
HCV RNA load, IU/mL (log10 IU/mL) 950,556 (5.98) 629,875 (5.80) 11,827 (4.07) 2,254,258 (6.35)
HCV RNA load fluctuation within 3 mo, log10 IU/mL 4.32 <1.00 1.33 <1.00
Unprotected anal intercourse No No No Serosorting‡
STI in previous 6 mo Proctitis Syphilis No Proctitis
Group sex (>2 persons) Yes No No No
Drug use Amyl nitrate only No No No

*HCV, hepatitis C virus; ART: antiretroviral therapy; AHC, acute hepatitis C infection; ALT, alanine aminotransferase; AST, aspartate aminotransferase; STI, sexually transmitted infection.
†Both patients had normal transaminase levels in the 4 y before AHC diagnosis.
‡Unprotected sex between seroconcordant partners (HIV positive).

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