Higher hepatitis C virus‐viral loads and complex sexual partners in hepatitis C virus‐human immunodeficiency virus coinfected injection drug users: A case‐control study

Abstract

Injection drug users (IDUs) are likely contributors to hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV) infections. However, little is known about the HCV viral loads of IDUs with HCV‐HIV coinfection. The aim of this prospective study was to investigate the HCV viral loads among IDUs with HCV infection, HCV‐HIV coinfection, and HCV‐HBV coinfection. Among the 45 IDUs recruited to the study, 27 were HCV monoinfected; 9 were HCV‐HIV coinfected; 7 were HCV‐HBV coinfected; and 2 were seronegative for HCV, HBV, or HIV infection. A control group of 180 age‐ and gender‐matched chronic HCV‐infected patients were enrolled using the propensity score method. A standardized case record form was used to collect demographic, clinical, laboratory, and virological data. The HCV RNA levels in IDUs with HCV‐HIV coinfection were significantly higher than those in the control group, IDUs with HCV monoinfection, and IDUs with HCV‐HBV coinfection (P < 0.001, P < 0.001, and P < 0.001, respectively). The HCV‐RNA levels in the control group were higher than those in IDUs with HCV monoinfection and HCV‐HBV coinfection (P = 0.04 and P = 0.039, respectively). After analyzing the risk factors related to these viral infections in IDUs, a complex sexual partner was more prevalent among IDUs with HCV‐HIV coinfection than those with HCV monoinfection or HCV‐HBV coinfection (P = 0.02 and P = 0.035, respectively). IDUs with HCV‐HIV coinfection demonstrated extremely high HCV‐RNA levels. Antiviral therapy, especially in the directly acting antiviral era, is indicated. In addition, IDUs with a complex sexual partner had a significantly higher risk of HIV infection. Therefore, the measure to curb this transmission is more important for infectious control.