{
  "abstract": "Background HCV transmission among MSM is associated with high-risk behaviours such as, group sex, sharing syringes, fisting, and chemsex practices (including slamming). Despite this, the Italian Medicines Agency (AIFA) requires semestral HCV testing for all PrEP users, without diversification according to risk factors. Our analysis aims to evaluate prevalence and incidence of HCV infection in a cohort of PrEP users in Milan.Material and Methods This retrospective analysis included all individuals who initiated PrEP at our outpatient clinic from 2018 to 2024. Demographic and behavioural variables were collected and analysed with descriptive and nonparametric statistics. Prevalence and incidence per 100 patient-years (100PYFU) were calculated. Standard survival analyses were used to estimate the risk of and factors associated with HCV acquisition.Results A total of 767 PrEP users were enrolled, predominantly cisgender men, whereas a small proportion were transgender (0.9%) or non-binary (0.4%). The median age was 35 (IQR 30-41) years. A low rate of chemsex use (17%) and sex work (1.8%) emerged. Visits occurred at 3-month intervals. The median number of sexual intercourses in the previous 3 months was 14 (IQR 7–24), including a median of 9 condomless sexual intercourses (IQR 3–20). Table 1 summarizes full demographic and behavioural data. Median follow-up was 1.27 years (IQR 0.06–5.89).Testing for HCV infection was positive in 7 cases, with a prevalence of 0.9% (95% CI 0.4-1.9), Over 992.6 person-years of follow-up, overall HCV incidence was 0.20 (95% CI 0.10-0.81) per 100 PYFU. Kaplan–Meier analysis (figure 1) showed a consistently low cumulative probability of HCV acquisition.In multivariable Cox regression analysis, condomless sex was independently associated with HCV acquisition (aHR per 10 episodes 1.48; 95% CI 1.01–2.19), as was receptive anal sex (aHR 5.12; 95% CI 3.07–8.54), after adjustment for chemsex use, age, sex at birth, and number of follow-up visits. Of note, chemsex did not result associated with HCV acquisition.Conclusion This study described a very low prevalence and incidence of HCV infection among PrEP users in Milan. Although HCV has been associated with chemsex use, this association was not significant in our cohort, likely due to the small number of reported chemsex. This finding reflects also the low rate of slam sex in Southern European populations.These data suggest the need of revising testing policies to optimize economic and healthcare staff resources.Abstract SC4 Table 1Abstract SC4 Figure 1",
  "authors": [
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "A Forni"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "F Peracchi"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "V Brogna"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "A Repishti"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "L Luzi"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "E Di Gennaro"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "G Cavazza"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"
      ],
      "name": "M Merli"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"
      ],
      "name": "N Bana"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"
      ],
      "name": "C Baiguera"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "M Puoti"
    },
    {
      "affiliations": [
        "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy",
        "University of Verona, Verona, Italy"
      ],
      "name": "R Rossotti"
    }
  ],
  "title": "SC4 Prevalence and incidence of HCV infection in a cohort of Italian PrEP users: too low to be relevant?",
  "uid": "147f3e9d-e5a4-57d0-8cc3-5628293964fc"
}