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Lack of decline in hepatitis C virus incidence among HIV-positive men who have sex with men during 1990-2014.

Abstract：

BACKGROUND & AIMS:Hepatitis C virus (HCV) incidence among HIV-positive men who have sex with men (MSM) has increased since 2000, although there are regional differences. We aimed to 1) estimate trends in HCV incidence among HIV-positive MSM, 2) assess the association between incidence and geographical region, age and HIV-related measurements and, 3) assess temporal changes from HIV seroconversion to HCV infection. METHODS:Data was used from MSM with well-estimated dates of HIV seroconversion from the CASCADE Collaboration (1990-2014). Smoothly varying trends in HCV incidence over time were allowed, using restricted cubic splines. The association of calendar year, age, CD4 count (lagged), HIV RNA (lagged), geographical region and HIV infection stage (recent vs. chronic) with HCV incidence were assessed using Poisson regression. RESULTS:Of 5,941 MSM, 337 acquired HCV during follow-up. HCV incidence significantly increased from 0.7/1,000 person-years in 1990 to 18/1,000 person-years in 2014. Recent calendar years, younger age, recent HIV infection and higher HIV RNA levels were significantly associated with HCV incidence, while CD4 count was not. Trends differed by geographical region; while incidence appeared to have stabilized in Western Europe and remained stable in Southern Europe, it continued to increase in Northern Europe in recent years. Time from HIV to HCV infection significantly decreased over time (p<0.001). CONCLUSIONS:HCV has continued to spread among HIV-positive MSM in recent years, but trends differ by geographical region. Interventions to decrease the risk of HCV acquisition and increase early diagnosis are warranted. LAY SUMMARY:Hepatitis C virus infection continues to spread among HIV-positive men who have sex with men, especially among younger individuals. However, trends seem to differ by European region in recent years. Furthermore, men who have sex with men with a higher HIV RNA load were more likely to get infected with the hepatitis C virus. During recent HIV infection, MSM appear to be at higher risk of acquiring hepatitis C.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

van Santen DK,van der Helm JJ,Del Amo J,Meyer L,D'Arminio Monforte A,Price M,Béguelin CA,Zangerle R,Sannes M,Porter K,Geskus RB,Prins M,CASCADE Collaboration in EuroCoord.

doi

10.1016/j.jhep.2017.03.038

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

255-262

issue

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(17)30209-X

journal_volume

pub_type

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Lack of decline in hepatitis C virus incidence among HIV-positive men who have sex with men during 1990-2014.