{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:32:54Z","timestamp":1792276374196,"version":"4.4.0"},"reference-count":25,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the transformative impact of direct-acting antivirals (DAAs) on hepatitis C control, acute\/recent hepatitis C virus (HCV) infections continue to be diagnosed in contemporary clinical practice. We describe acute\/recent HCV cases diagnosed at a tertiary hospital in Madrid among men who have sex with men (MSM), including people living with HIV (PLHIV) and pre-exposure prophylaxis (PrEP) users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, single-centre descriptive study including acute\/recent HCV cases reported between January 2023 and January 2025. Cases were defined by detectable HCV RNA following a previously negative HCV serology or after a cured HCV infection (reinfection). Chemsex was defined as intentional use of psychoactive substances in sexual contexts; slamsex as injecting drugs in sexual contexts. Patients initially managed with watchful waiting were reassessed at 12 weeks to assess spontaneous clearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-two cases were included; median age was 43 years (IQR 36\u201352)\u2009and 24 (26.1%) were &gt;50 years. In total, 91 out of 92 (98.9%) were MSM; 70 (76.1%) were PLHIV and 19 (20.7%) were PrEP users. Among 84 patients with genotype data, 55 (59.8%) had genotype 1a, 8 (8.7%) 1b, and 21 (22.8%) genotype 4. HCV RNA was &gt;6\u2009log in 41 (44.6%) and &gt;7\u2009log in 18 (19.6%). Chemsex was reported by 72 (78.3%); among them, 38 (52.8%) reported slamsex. Among those with available data, 17 out of 54 (31.5%) had another sexually transmitted infection. Watchful waiting was initially adopted in 73 (79.3%); 5 out of 73 (6.8%) achieved spontaneous clearance at 12 weeks. Of those observed, 68 (93.2%) initiated DAAs; 9 (9.8%) were treated at diagnosis. Ten (10.9%) were lost to follow-up before treatment initiation; sustained virological response was achieved in treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute\/recent HCV diagnoses occurred predominantly among MSM, including PLHIV and PrEP users, with frequent reporting of chemsex\/slamsex. Low spontaneous clearance and losses before treatment initiation highlight the need for targeted HCV testing and linkage to care in HIV\/PrEP and sexual health services, alongside harm reduction and substance use support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056844","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:20:18Z","timestamp":1780939218000},"page":"sextrans-2025-056844","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Acute hepatitis C related to chemsex: insights from a Spanish cohort"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0635-364X","authenticated-orcid":false,"given":"Elia","family":"Asensi D\u00edaz","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"\u00c1lvarez \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7181-8163","authenticated-orcid":false,"given":"Angel Luis","family":"Casta\u00f1o N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Immunology. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Prieto-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"L\u00f3pez de las Heras","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6060-8224","authenticated-orcid":false,"given":"Irene","family":"Carrillo-Acosta","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aws","family":"Waleed Al-Hayani","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Tellez P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Immunology. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"G\u00f3rgolas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Cabello","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital. Research Health Institute, Aut\u00f3noma de Madrid University (IIS-FJD, UAM), Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026060810201173000_sextrans-2025-056844v1.1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.eimc.2024.08.003","article-title":"Acute and recent hepatitis C virus (HCV) infections in men having sex with men (MSM): is the test&treat strategy fundamental to reduce the incidence in this population?","volume":"42","author":"G\u00f3mez Ayerbe","year":"2024","journal-title":"Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica"},{"key":"2026060810201173000_sextrans-2025-056844v1.2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S2468-1253(20)30303-4","article-title":"Prevalence and incidence of hepatitis C virus infection in men who have sex with men: a systematic review and meta-analysis","volume":"6","author":"Jin","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2026060810201173000_sextrans-2025-056844v1.3","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/cid\/ciaa645","article-title":"Incidence of HCV Reinfection Among HIV-Positive MSM and Its Association With Sexual Risk Behavior: A Longitudinal Analysis","volume":"73","author":"Newsum","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026060810201173000_sextrans-2025-056844v1.4","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad401","article-title":"Incidence and Prevalence of Hepatitis C Virus Among HIV-Negative Gay and Bisexual Men Using HIV Pre-exposure Prophylaxis (PrEP): A Systematic Review and Meta-analysis","volume":"10","author":"Traeger","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2026060810201173000_sextrans-2025-056844v1.5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.22206\/cisa.2024.v8i2.pp75-86","article-title":"Profilaxis pre-exposici\u00f3n de VIH en hombres que tienen sexo con otros hombres y su influencia en otras enfermedades de transmisi\u00f3n sexual: una revisi\u00f3n bibliogr\u00e1fica","volume":"8","author":"V\u00e1zquez-G\u00f3mez","year":"2024","journal-title":"Cisa"},{"key":"2026060810201173000_sextrans-2025-056844v1.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0220272","article-title":"Drug-related and psychopathological symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study","volume":"14","author":"Dolengevich-Segal","year":"2019","journal-title":"PLoS One"},{"key":"2026060810201173000_sextrans-2025-056844v1.7","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1089\/apc.2017.0263","article-title":"Sexualized Drug Use (Chemsex) Is Associated with High-Risk Sexual Behaviors and Sexually Transmitted Infections in HIV-Positive Men Who Have Sex with Men: Data from the U-SEX GESIDA 9416 Study","volume":"32","author":"Gonz\u00e1lez-Baeza","year":"2018","journal-title":"AIDS Patient Care STDS"},{"key":"2026060810201173000_sextrans-2025-056844v1.8","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10081662","article-title":"Chemsex Practices and Health-Related Quality of Life in Spanish Men with HIV Who Have Sex with Men","volume":"10","author":"Ruiz-Robledillo","year":"2021","journal-title":"J Clin Med"},{"key":"2026060810201173000_sextrans-2025-056844v1.9","unstructured":"Centers for Disease Control and Prevention . 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