Interventions are needed to prevent sexually-acquired hepatitis C virus (HCV) infections by men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) against human immunodeficiency virus (HIV) infection, a recent report concluded. With the introduction of PrEP against HIV, researchers hypothesized that these infections would increase. They found:

• Between 2013 and 2018, 15 likely sexually-acquired HCV infections were diagnosed among 14 MSM using PrEP.
• 87% of these infections were asymptomatic, detected by routine ALT or HCV monitoring.
• Half of the study population reported increasing sex partners and drug use after starting PrEP.
• CDC guidelines for monitoring during PrEP should include regular ALT and HCV testing.