Prevalent and incident hepatitis C virus infection among HIV-infected men who have sex with men engaged in primary care in a Boston community health center.
Open accessAbstract
BACKGROUND: Sexually transmitted hepatitis C virus (HCV) infection is an emerging epidemic among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). HCV may be underrecognized in this population, historically thought to be at low risk. METHODS: We determined the prevalence and incidence of HCV among HIV-infected men at Fenway Health between 1997 and 2009. We describe characteristics associated with HCV. RESULTS: Of 1171 HIV-infected men, of whom 96% identify as MSM, 1068 (91%) were screened for HCV and 64 (6%) had a positive HCV antibody (Ab) result at initial screening. Among the 995 men whose initial HCV Ab result was negative, 62% received no further HCV Ab testing. Among the 377 men who had ≥1 additional HCV Ab test, 23 (6%) seroconverted over 1408 person-years, for an annualized incidence of 1.63 per 100 person-years (95% confidence interval, .97-2.30). Among the 87 HIV-infected MSM diagnosed with prevalent or incident HCV, 33% reported history of injection drug use, 46% noninjection drug use (NIDU), and 70% sexually transmitted infections (STIs). Sixty-four (74%) of HCV-infected MSM developed chronic HCV; 22 (34%) initiated HCV treatment and 13 (59%) of treated persons achieved a sustained virologic response (SVR). CONCLUSIONS: Prevalent and incident HCV, primarily acquired through nonparenteral means, was common in this HIV-infected population despite engagement in care. STIs and NIDU were common among HIV/HCV-coinfected MSM. SVR rates were high among those who underwent HCV treatment. All sexually active and/or substance-using HIV-infected MSM should receive routine and repeated HCV screening to allow for early diagnosis and treatment of HCV.
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Sexual transmission of HCV can occur and is most common among MSM with HIV infection.
“Sexual transmission of HCV can occur and is most common among MSM with HIV infection (234–237).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [236]
The Abstract describes sexually transmitted HCV as an emerging epidemic among MSM with HIV, and the Discussion says high-risk sexual behaviors appear to play a role in transmission. The paper does not compare sexual HCV transmission across populations, so it does not establish that it is most common among MSM with HIV. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIncreasing incidence of acute HCV infection among MSM with HIV infection has been reported in multiple U.S. and European cities.
“Increasing incidence of acute HCV infection among MSM with HIV infection has been reported in multiple U.S. (96,236,239,1339) and European cities (237,1340–1342).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [236]
The Results report that diagnosed incident HCV cases increased over time at the Boston clinic. But the paper does not establish an increasing incidence rate across multiple U.S. cities, and the Discussion says it could not determine whether incident cases were acute infections. It separately reports increasing incidence in European cohorts; the cited paper supports a narrower U.S. finding than the claim attributes to it. (LLM, conf=0.88)
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- Authors
- Garg, S., Taylor, L. E., Grasso, C., & Mayer, K. H.
- Affiliations
- Tufts Medical Center (US)
- Brown University (US)
- Fenway Health (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Garg, S.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-02-05
- Volume
- 56
- Issue
- 10
- Pages
- 1480-1487
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC3634307
- OpenAlex
- W2102616164
- Cited by
- 38
- References
- 44
- Citations by year
- 2024: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 11 · 2015: 4 · 2014: 4 · 2013: 5
- FWCI
- 4.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5t32ai007438-20)
- National Institute on Drug Abuse (K23DA020383)
- National Institute of Allergy and Infectious Diseases (T32-AI007438, 5T32AI007438-17, P30AI042853)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- hepatitis C virus, HIV/HCV coinfection, men who have sex with men, sexually transmitted infections, HCV screening, HCV seroconversion, chronic hepatitis C, sustained virological response, hepatitis C treatment, primary care
- MeSH terms
- Adolescent, Adult, Aged, Boston, Community Health Centers, Hepatitis C, Humans, Male, Mass Screening, Middle Aged, Retrospective Studies, HIV Infections, Incidence, Prevalence, Homosexuality, Male, Statistics, Nonparametric
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