TY - JOUR
T1 - Incident hepatitis C virus infection in men who have sex with men
T2 - A prospective cohort analysis, 1984-2011
AU - Witt, Mallory D.
AU - Seaberg, Eric C.
AU - Darilay, Annie
AU - Young, Stephen
AU - Badri, Sheila
AU - Rinaldo, Charles R.
AU - Jacobson, Lisa P.
AU - Detels, Roger
AU - Thio, Chloe L.
N1 - Funding Information:
Financial support. Data in this manuscript were collected by the MACS (http://www.statepi.jhsph.edu/macs/macs.html) with centers (Principal Investigators) at The Johns Hopkins Bloomberg School of Public Health ( Joseph B. Margolick, Lisa P. Jacobson), Howard Brown Health Center, Feinberg School of Medicine, Northwestern University, and Cook County Bureau of Health Services ( John P. Phair, Steven M. Wolinsky), University of California, Los Angeles (Roger Detels), and University of Pittsburgh (Charles R. Rinaldo). The MACS is funded by the National Institute of Allergy and Infectious Diseases, with additional supplemental funding from the National Cancer Institute (UO1-AI-35042, UL1-RR025005, UO1-AI-35043, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041).
PY - 2013/7
Y1 - 2013/7
N2 - Background Prospective characterization of hepatitis C virus (HCV) transmission in both human immunodeficiency virus (HIV)-infected and-uninfected men who have sex with men (MSM) over the entire HIV epidemic has not been comprehensively conducted.Methods To determine the trends in and risk factors associated with incident HCV in MSM since 1984, 5310 HCV antibody (anti-HCV)-negative MSM in the Multicenter AIDS Cohort Study were prospectively followed during 1984-2011 for anti-HCV seroconversion.Results During 55 343 person-years (PYs) of follow-up, there were 115 incident HCV infections (incidence rate, 2.08/1000 PYs) scattered throughout the study period. In a multivariable analysis with time-varying covariates, older age (incidence rate ratio [IRR], 1.40/10 years, P <. 001), enrollment in the later (2001-2003) recruitment period (IRR, 3.80, P =. 001), HIV infection (IRR, 5.98, P <. 001), drinking >13 alcoholic drinks per week (IRR, 1.68, P <. 001), hepatitis B surface antigen positivity (IRR, 1.68, P <. 001), syphilis (IRR, 2.95, P <. 001), and unprotected receptive anal intercourse with >1 male partner (IRR, 3.37, P <. 001) were independently associated with incident HCV. Among HIV-infected subjects, every 100 cell/mm3 increase in CD4 count was associated with a 7% (P =. 002) decrease in the HCV incidence rate up to a CD4 count of 500 cells/mm3, whereas there was no association with highly active antiretroviral therapy.Conclusions The spread of HCV among both HIV-infected and-uninfected MSM in the United States has been ongoing since the beginning of the HIV epidemic. In HIV-infected men with <500 CD4 + T cells, the HCV incidence rate was inversely proportional to CD4 T-cell count.
AB - Background Prospective characterization of hepatitis C virus (HCV) transmission in both human immunodeficiency virus (HIV)-infected and-uninfected men who have sex with men (MSM) over the entire HIV epidemic has not been comprehensively conducted.Methods To determine the trends in and risk factors associated with incident HCV in MSM since 1984, 5310 HCV antibody (anti-HCV)-negative MSM in the Multicenter AIDS Cohort Study were prospectively followed during 1984-2011 for anti-HCV seroconversion.Results During 55 343 person-years (PYs) of follow-up, there were 115 incident HCV infections (incidence rate, 2.08/1000 PYs) scattered throughout the study period. In a multivariable analysis with time-varying covariates, older age (incidence rate ratio [IRR], 1.40/10 years, P <. 001), enrollment in the later (2001-2003) recruitment period (IRR, 3.80, P =. 001), HIV infection (IRR, 5.98, P <. 001), drinking >13 alcoholic drinks per week (IRR, 1.68, P <. 001), hepatitis B surface antigen positivity (IRR, 1.68, P <. 001), syphilis (IRR, 2.95, P <. 001), and unprotected receptive anal intercourse with >1 male partner (IRR, 3.37, P <. 001) were independently associated with incident HCV. Among HIV-infected subjects, every 100 cell/mm3 increase in CD4 count was associated with a 7% (P =. 002) decrease in the HCV incidence rate up to a CD4 count of 500 cells/mm3, whereas there was no association with highly active antiretroviral therapy.Conclusions The spread of HCV among both HIV-infected and-uninfected MSM in the United States has been ongoing since the beginning of the HIV epidemic. In HIV-infected men with <500 CD4 + T cells, the HCV incidence rate was inversely proportional to CD4 T-cell count.
KW - MSM
KW - incident HCV
KW - sexual transmission
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U2 - 10.1093/cid/cit197
DO - 10.1093/cid/cit197
M3 - Article
C2 - 23532480
AN - SCOPUS:84878879884
SN - 1058-4838
VL - 57
SP - 77
EP - 84
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -