Abstract
BackgroundHepatitis C virus (HCV) has been mainly transmitted through injection drug use, but recently, sexual transmission among men who have sex with men (MSM), which is also a major route of HIV transmission, is increasing. However, the prevalence of HIV and the incidence of other sexually transmitted infections (STIs) among HCV patients have been rarely reported.MethodsUsing a healthcare insurance claim data of employees and their dependents covering seven-million people in Japan, we evaluated HIV prevalence among HCV patients aged 20–59 years. Hemophilia patients were excluded. HIV and HCV were defined by registered diagnoses and receiving viral RNA testing. The time course of HCV and HIV infections was analyzed. Incidences of syphilis, amebiasis, chlamydia, gonorrhea, hepatitis A, and hepatitis B were assessed.ResultsFrom April 2012 to August 2018, 6,422 HCV patients were identified. HIV prevalence was 0.48% (31/6422, 95% CI [confidence interval]: 0.33–0.68%). HIV was diagnosed after HCV in 3.2% (1/31), before HCV in 58.1% (18/31), and concurrently in 38.7% (12/31). Compared with HCV patients without HIV infection, HCV/HIV co-infected patients were younger (median age, 37 vs 51 years, p < 0.001), more likely to be male (30/31 [96.8%] vs 3059/6391 [47.9%], p < 0.001), more likely to have other STIs (38.7% [12/31] vs 0.9% [56/6391], p < 0.001), and live in Tokyo, the most populous capital city in Japan (67.7% [21/31] vs 11.6% [742/6391], p < 0.001). In Tokyo, the HIV prevalence among 20–30 s male with HCV was 18.6% (13/70; 95% CI, 10.3–29.7%).ConclusionsHIV prevalence among young male HCV patients was very high in Tokyo. HCV/HIV co-infected patients were more likely to acquire HIV before HCV, which is a known feature of MSM. They also had a higher incidence of STIs. These findings suggest that HCV might be prevalent as an STI among MSM particularly in Tokyo.
Highlights
An estimated 1.0% of people in the world are infected with hepatitis C virus (HCV), leading to 475,000 deaths in 2015 [1]
Injection drug use is regarded as the main mode of transmission of Hepatitis C virus (HCV) partly because HCV had been considered rarely transmitted by sexual contact; the transmission rate of HCV between non-HIV heterosexual partners were estimated to be one infection per 190,000 sexual contacts [9]
7865 patients were performed at least one HCV-RNA test during the study period, and 1383 patients were excluded by the age criterion
Summary
An estimated 1.0% of people in the world are infected with hepatitis C virus (HCV), leading to 475,000 deaths in 2015 [1]. HCV and HIV share similar routes of transmission: injection drug use, contaminated blood products, and sexual contact [7]. Many hemophilia patients got HIV, HCV, and hepatitis B virus (HBV) due to contaminated blood products, until the 1990s when the screening of these infections became a standard worldwide. Hepatitis C virus (HCV) has been mainly transmitted through injection drug use, but recently, sexual transmission among men who have sex with men (MSM), which is a major route of HIV transmission, is increasing. The prevalence of HIV and the incidence of other sexually transmitted infections (STIs) among HCV patients have been rarely reported
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