Abstract
BackgroundAcute hepatitis C virus (HCV) infection (AHCVI) outbreaks have been described recently within defined areas worldwide among HIV-infected homosexual men. This study aims to describe the cumulative frequency and incidence of firstly acquired AHCVI in an HIV-infected population in Southern Spain.MethodsThis is a retrospective study conducted at the Infectious Diseases Units of eight hospitals in Andalusia, Southern Spain. Primary AHC was considered as HCV immunoglobulin G antibody seroconversion. The time of infection was considered the moment between the last negative and the first positive HCV antibody determination.ResultsA total of 23 cases of primary AHCVI have been detected from 2000 to 2014. Incidence rates [IR; 95 % confidence interval (CI)] were 0.036 (2.272–0.054) per 100 person-years (py) in the overall population over a follow-up period of 64170 py. Of the 22 (95.7 %) male subjects, 21 (95.5 %) had acquired AHCVI by homosexual contact, the IR (95 % CI) was 0.039 (0.024–0.06) per 100 py in this subpopulation. There was no evidence of an increase of AHCVI IR. The incidence of AHCVI was slightly lower between 2000 and 2004 as compared to 2005–2009 [IR ratio (IRR) of 8.8 (95 % CI: 1.279–378.794; p = 0.01)] but reached a plateau afterwards [IRR between 2010 and 2014 versus 2005–2009: 0.727 (0.286–1.848; p = 0.5)]. The median (Q1-Q3) time between the last negative anti-HCV and the first positive anti-HCV determination was 4.7 (1.9–11.2) months. Peak (Q1-Q3) ALT and total bilirubin values during AHCVI were 496 (291–656) IU/mL and 1.15 (0.9–1.98) mg/dL, respectively.ConclusionsIn contrast to what has been reported from other areas, the incidence of primary AHCVI in the HIV-infected population is stable in Southern Spain and there is no evidence of an epidemic, in spite of the high prevalence of HIV/HCV-coinfection in this area.
Highlights
Acute hepatitis C virus (HCV) infection (AHCVI) outbreaks have been described recently within defined areas worldwide among HIV-infected homosexual men
To provide insight on this point, this study aimed to determine the number of cases of firstly acquired acute hepatitis C virus infection (AHCVI) infection among HIV-infected patients seen at eight Southern Spanish hospitals, who attend a vast population of HIVinfected individuals with high prevalence of HCV coinfection
All of them were observed in five of the eight participating hospitals: 10 cases were reported from Malaga and the remaining 13 individuals were identified in Seville
Summary
Acute hepatitis C virus (HCV) infection (AHCVI) outbreaks have been described recently within defined areas worldwide among HIV-infected homosexual men. No cases of AHCVI among the HIV-infected population from Southern Spain have been published, in spite of the fact that in this area over one third of HIVinfected subjects currently bear an active HCV coinfection [11]. This might suggest that, whatever the reason, the occurrence of acute HCV infection outbreaks among HIV-infected MSM is subject to regional variations. To provide insight on this point, this study aimed to determine the number of cases of firstly acquired AHCVI infection among HIV-infected patients seen at eight Southern Spanish hospitals, who attend a vast population of HIVinfected individuals with high prevalence of HCV coinfection
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