Acute Hepatitis C Infection in a MSM Living With HIV in Trinidad.

Hepatitis C virus (HCV) infection is widespread globally, however the data on HCV is sparse in the anglophone Caribbean particularly among persons living with HIV. Acute HCV infection is frequently asymptomatic and in resource limited countries, there are numerous challenges with diagnosis and treatment. We present the case of a 45 year old man who has sex with men (MSM) living with HIV in Trinidad with sexually acquired HCV infection in whom there were elevated liver transaminases and low HCV RNA levels that signified a strong immune mediated response in an attempt to clear the virus, but this was ultimately unsuccessful resulting in chronic infection. This case highlights the importance of maintaining a high index of suspicion for hepatitis C among MSM living with HIV without a history of injection drug use and the many obstacles that were encountered in the medical management of this patient.