Incidence of hepatitis-C among HIV infected men who have sex with men (MSM) attending a sexual health service: a cohort study.

Deepa G Gamage,Tim R H Read,Jane S Hocking,Christopher K Fairley,Marcus Y Chen,Catriona S Bradshaw,Kerry Howley

doi:10.1186/1471-2334-11-39

Abstract

BackgroundWe aimed to determine the incidence of Hepatitis C (HCV) infection among HIV-infected men who have sex with men (MSM) attending a Sexual Health Centre.MethodsA retrospective cohort study was carried out among HIV-infected MSM seen at least once between February 2002 and March 2010. The analysis was restricted to MSM who had had a negative HCV antibody test at least 6 months after their diagnosis for HIV. Duration of follow up was taken from the date of HIV diagnosis to the first positive or last negative HCV antibody test.ResultsDuring the time 1445 HIV-infected men attended the clinic of whom 1065 (74%) were MSM. Of these, 869 (82%) were tested for HCV at any time after HIV diagnosis. Of these 869, 69% (620) tested HCV negative at least 6 months after their HIV diagnosis. These 620 men had a mean age of 34 years (range 17-72) at HIV diagnosis and a total of 4,359 person years (PY) of follow up. There were 40 incident cases of HCV, of which 16 were in injecting drug users (IDU) and 24 in non-IDU. The overall incidence of HCV among HIV-infected MSM was 0.9/100 PY (95% CI 0.6-1.2). The incidence among HIV-infected IDU was 4.7/100 PY (95% CI 2.7-7.5) while the incidence among HIV-infected non-IDU was 0.6/100 PY (95% CI 0.4-0.8) (hazard ratio of 8.7 and 95% CI 4.6-16.6, P < 0.001).The majority (78%) were tested for HCV because they developed abnormal liver transaminases (n = 31) or hepatitis symptoms (n = 2), while others (n = 7) were identified through routine HCV testing.ConclusionA considerable proportion of HIV-positive MSM who did not inject drugs contracted HCV, presumably via sexual transmission and the main trigger for investigation was abnormal liver transaminases.

Highlights

We aimed to determine the incidence of Hepatitis C (HCV) infection among Human Immunodeficiency Virus (HIV)-infected men who have sex with men (MSM) attending a Sexual Health Centre
Individuals who tested positive for Hepatitis C virus (HCV) antibodies at their first HCV antibody test were excluded from the cohort analysis because they could not be confirmed as incident cases
There were 1445 HIV infected males seen at least once at Melbourne Sexual Health Centre (MSHC) during the eight year period. Of these 1065 (74%) were MSM and of these 869 (82%) were tested for HCV at any time after HIV diagnosis. Of these 869, we excluded 180 HCV-negatives because their last HCV test was less than 6 months after their first HIV positive test

Summary

Introduction

We aimed to determine the incidence of Hepatitis C (HCV) infection among HIV-infected men who have sex with men (MSM) attending a Sexual Health Centre. Hepatitis C virus (HCV) infection is a significant health issue, among individuals with HIV infection [1,2]. Hepatitis C infection is transmitted mainly by parenteral exposure, in IDU [5]. It remains unclear whether HCV is transmitted sexually between men, and Recently a number of bodies have recommended screening for HCV among MSM with HIV, even in the absence of any known risk factors for HCV infection [14]. We carried out a retrospective cohort study to determine the incidence of possible sexual transmission among those who did not inject drugs

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