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. 2025 Oct 1;39(12):1803-1812.
doi: 10.1097/QAD.0000000000004265. Epub 2025 Jun 20.

The impact of the COVID-19 and mpox outbreaks on behaviours associated with HCV infection among MSM: results from the prerandomisation phase of a clinical trial

Kris Hage  1   2   3 , Anders Boyd  1   2   3   4 , Udi Davidovich  1   5 , Ellen Generaal  1   3 , Elske Hoornenborg  1   3 , Paul Zantkuijl  6 , Marc van der Valk  2   3   4 , Dominique Verhagen  7 , Janneke Stalenhoef  8 , Jan den Hollander  9 , Eliane Leyten  10 , Tania Mudrikova  11 , Hayette Rougier  12 , Thibault Chiarabini  13 , Marc-Antoine Valantin  14   15 , Gilles Pialoux  16 , Pauline Campa  13   17 , Janke Schinkel  18 , Karine Lacombe  13   15 , Maria Prins  1   2   3 ; ICECREAM study group
Affiliations

The impact of the COVID-19 and mpox outbreaks on behaviours associated with HCV infection among MSM: results from the prerandomisation phase of a clinical trial

Kris Hage et al. AIDS. .

Abstract

Objective: To assess whether the COVID-19 and mpox outbreaks affected hepatitis C virus (HCV) related behaviours among men who have sex with men (MSM) with a cleared HCV infection.

Design: Longitudinal analysis from the international ICECREAM trial (2021-2024).

Methods: During the prerandomisation phase (i.e., without any intervention) individuals completed questionnaires on sexual and drug use behaviours and whether the COVID-19 (since start trial) or mpox (shortly after the mpox outbreak in 2022) outbreaks caused changes in these behaviours, all referring to the preceding 6 months. We used mixed-effects logistic regression to model changes in behaviours due to COVID-19 or mpox measures and mixed-effects linear regression to model the average HCV-MOSAIC risk score, as a proxy of HCV-associated risk behaviour, over calendar time.

Results: 220 MSM ( n = 117 from the Netherlands, n = 103 from France) were included. Among 208 that completed the baseline questionnaire, 171 (82.2%) were MSM with HIV. The proportion of individuals reporting any impact of COVID-19 restrictions on risk behaviours, mainly lowering number of partners, decreased from 74.7% in September 2021 to 6.7% in September 2024 ( P < 0.001) and reporting any impact of mpox from 41.9% in November 2022 to 6.0% in September 2024 ( P = 0.001). The average HCV-MOSAIC risk score remained constant over time ( P = 0.59) and was consistently ≥2.0, indicating high reinfection susceptibility.

Conclusion: HCV-related behaviours decreased when COVID-19 and mpox measures were in place. However, individuals still engaged in behaviours associated with HCV, highlighting the importance of continued sexual health services and prevention efforts during such outbreaks.

Keywords: COVID-19 restrictions; hepatitis C virus; men who have sex with men; mpox; sexual and drug use behaviours.

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Conflict of interest statement

A.B. has received a speakers fee from Gilead Sciences, independent for the submitted work. EH's institution has received independent scientific support from Gilead Sciences. M.vdV.'s institution has received consultancy fees from Gilead, MSD and ViiV outside the submitted work and research grants from Gilead, Merck Sharp Dome and ViiV. J.dH. has received consultancy fees from Gilead, MSD and ViiV outside the submitted work. T.M.'s institution has received consultancy fees from ViiV, Gilead and MSD, and research grants from ViiV and Gilead, unrelated to the submitted work. K.L. has received speakers fees and independent scientific support from Gilead Sciences, MSD, and ViiV Healthcare, outside the submitted work. MP's institution has received speakers fees and independent scientific support from Gilead Sciences, Roche, MSD, and Abbvie, outside the submitted work. All other authors report no potential conflicts.

Figures

Fig. 1
Fig. 1
Overall cumulative proportion of MSM who reported a reduction in sexual and drug use behaviours impacted by the COVID-19 restrictions and mpox measures in the past six months in the period September 2021–September 2024.
Fig. 2
Fig. 2
Proportion reporting any effect of (a) COVID-19 restrictions and (b) mpox on sexual and drug use behaviour associated with HCV in the preceding six months over calendar time among included MSM.
Fig. 3
Fig. 3
Average predicted HCV-MOSAIC risk score over time among included MSM between September 2021 and September 2024.
See this image and copyright information in PMC

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