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

van Santen, DK; van der Helm, JJ; Del Amo, J; Meyer, L; Monforte, AD; Price, M; Beguelin, CA; ... Prins, M; + view all (2017) Lack of decline in hepatitis C virus incidence among HIV-positive men who have sex with men during 1990-2014. Journal of Hepatology , 67 (2) pp. 255-262. 10.1016/j.jhep.2017.03.038. Green open access

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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.

Type: Article
Title: Lack of decline in hepatitis C virus incidence among HIV-positive men who have sex with men during 1990-2014
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jhep.2017.03.038
Publisher version: http://dx.doi.org/10.1016/j.jhep.2017.03.038
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, Hepatitis C, Incidence, HIV seroconverters, Men who have sex with men, HIV RNA, INFECTED MEN, RISK-FACTORS, HCV, EPIDEMIC, COHORT, MSM, TRENDS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10044340
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