June 11, 2013
Researchers at Johns Hopkins University (JHU) prospectively followed 5,310 men who have sex with men (MSM) enrolled in the Multicenter AIDS Cohort Study. The participants were men with HIV infection and men at risk for HIV. All the participants tested negative for hepatitis C virus (HCV) antibody within two years of enrollment and at follow-up visits through September 30, 2011.
The researchers followed the group for a median of 7.1 years for a total of 55,343 years of follow-up. During follow-up, researchers documented 115 incidences of HCV infection, with an incidence rate of 2.08 per 1,000 person-years. HIV-positive men had a 4.22 HCV infection rate, approximately 8.5 times higher than the 0.5 rate for men who did not have HIV.
Factors associated with increased HCV risk were older age, HIV infection, being positive for hepatitis B, history of injection drug use, having more than 13 drinks a week, syphilis, and unprotected receptive anal sex with multiple partners in the previous six months. Among HIV-positive MSM, HCV risk decreased as CD4 cell counts increased.
Chloe Thio, M.D., associate professor of medicine at JHU, noted that the data emphasized the importance of screening MSM for HCV regardless of whether they were sexually active as they might have been infected many years ago. Also, she suggested patients should be counseled about the increased risk to receptive partners.
The full report, "Incident Hepatitis C Virus Infection in Men Who Have Sex With Men: A Prospective Cohort Analysis, 1984-2011," was published in the journal Clinical Infectious Diseases, (2013; 57 (1): 77-84).