Abstract
Background: The disease burden of hepatitis C virus (HCV) infection in HIV-positive and HIV-negative men who have sex with men (MSM) is changing. We aim to provide an updated comprehensive estimate of HCV prevalence and incidence among the HIV-positive and HIV-negative MSM population at the country, regional, and global levels and their changing trends over time.Methods: PubMed, Embase, PsycINFO, CINAHL, and conference databases were searched and eligible records on the prevalence and incidence of HCV antibodies were selected and pooled via a random-effects model. Meta-regression was performed to demonstrate the association between the pooled rates and study year.Results: A total of 230 articles reporting 245 records from 51 countries with 445,883 participants and 704,249 follow-up person-years were included. The pooled prevalence of HCV in MSM was 5.9% (95% CI: 5.1–6.8), with substantial differences between countries and regions. Low- and lower-middle-income countries (12.3 and 7.0%) manifested a larger disease burden than high- and upper-middle-income countries (5.8 and 3.8%). HCV prevalence in HIV-positive MSM was substantially higher than in HIV-negative MSM (8.1 vs. 2.8%, p < 0.001). The pooled incidence of HCV was 8.6 (95% CI: 7.2–10.0) per 1,000 person-years, with an increasing trend over time, according to meta-regression (p < 0.05).Conclusion: Global HCV prevalence in MSM varies by region and HIV status. Behavior counseling and regular HCV monitoring are needed in HIV-positive subgroups and high-risk regions. Given the upward trend of HCV incidence and sexual risk behaviors, there is also a continued need to reinforce risk-reduction intervention.Systematic Review Registration: PROSPERO, identifier CRD42020211028; https://www.crd.york.ac.uk/prospero/.
Highlights
Hepatitis C virus (HCV) infection is a global public health threat
Acute HCV infection persists for ∼6 months and 55–85% of patients with acute hepatitis C transition to chronic hepatitis C, which may cause a series of end-stage liver diseases, such as chronic liver disease, cirrhosis, and hepatocellular carcinoma, in ∼20–30 years in some patients [2]
We comprehensively searched the traditional databases of PubMed, Embase, PsycINFO, and CINAHL using a combination of medical subject headings and free text including terms related to HCV, men who have sex with men (MSM), and prevalence
Summary
Hepatitis C virus (HCV) infection is a global public health threat. It was estimated that there were 71 million persons living with chronic HCV infection worldwide and 1.75 million new HCV infections in 2015 [1]. In men who have sex with men (MSM), an excess risk of sexual HCV transmission has commonly been reported, especially for those who are concurrently infected with HIV. Since the year 2000, several studies have reported an expanding epidemic of sexually transmitted acute HCV infection in HIV-positive MSM in North America, Europe, Australia, and Asia [4, 5]. Behavioral factors such as increased high-risk sexual behavior and decreased precautionary measures are believed to increase the HCV infection risk for HIV-positive MSM [7]. The disease burden of hepatitis C virus (HCV) infection in HIV-positive and HIV-negative men who have sex with men (MSM) is changing. We aim to provide an updated comprehensive estimate of HCV prevalence and incidence among the HIV-positive and HIV-negative MSM population at the country, regional, and global levels and their changing trends over time
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