Department of Infectious Diseases, Bern University Hospital and University of Bern, Switzerland.
Clin Infect Dis. 2012 Nov 15;55(10):1408-16. doi: 10.1093/cid/cis694. Epub 2012 Aug 14.
Hepatitis C virus (HCV) infection has a growing impact on morbidity and mortality in patients infected with human immunodeficiency virus (HIV). We assessed trends in HCV incidence in the different HIV transmission groups in the Swiss HIV Cohort Study (SHCS).
HCV infection incidence was assessed from 1998, when routine serial HCV screening was introduced in the SHCS, until 2011. All HCV-seronegative patients with at least 1 follow-up serology were included. Incidence rates (IRs) of HCV infections were compared between men who have sex with men (MSM), injection drug users (IDU), and heterosexuals (HET).
HCV incidence was assessed in 3333 MSM, 123 IDU, and 3078 HET with a negative HCV serology at baseline. Over 23 707 person-years (py) for MSM, 733 py for IDU, and 20 752 py for HET, 101 (3%), 41 (33%), and 25 (1%) of patients seroconverted, respectively. The IR of HCV infections in MSM increased from 0.23 (95% credible interval [CrI], .08-.54) per 100 py in 1998 to 4.09 (95% CrI, 2.57-6.18) in 2011. The IR decreased in IDU and remained <1 per 100 py in HET. In MSM, history of inconsistent condom use (adjusted hazard ratio [HR], 2.09; 95% CI, 1.33-3.29) and past syphilis (adjusted HR, 2.11; 95% confidence interval [CI], 1.39-3.20) predicted HCV seroconversion.
In the SHCS, HCV infection incidence decreased in IDU, remained stable in HET, and increased 18-fold in MSM in the last 13 years. These observations underscore the need for improved HCV surveillance and prevention among HIV-infected MSM.
丙型肝炎病毒（HCV）感染对感染人类免疫缺陷病毒（HIV）的患者的发病率和死亡率有着日益增长的影响。我们评估了瑞士艾滋病毒队列研究（SHCS）中不同 HIV 传播组中 HCV 发病率的趋势。
从 1998 年开始，当 SHCS 中引入常规连续 HCV 筛查时，评估 HCV 感染的发病率，直到 2011 年。所有 HCV 血清阴性且至少有 1 次随访血清学检查的患者均被纳入。比较了男男性行为者（MSM）、注射吸毒者（IDU）和异性恋者（HET）之间的 HCV 感染发病率（IR）。
在基线时 HCV 血清学阴性的 3333 名 MSM、123 名 IDU 和 3078 名 HET 中评估了 HCV 发病率。MSM 为 23707 人年（py），IDU 为 733 py，HET 为 20752 py，分别有 101（3%）、41（33%）和 25（1%）例患者发生血清学转换。MSM 的 HCV 感染发病率从 1998 年的每 100 py 0.23（95%可信区间[CrI]，0.08-0.54）增加到 2011 年的每 100 py 4.09（95% CrI，2.57-6.18）。IDU 中的发病率下降，而 HET 中仍低于每 100 py 1 例。在 MSM 中， condom 使用不规律（调整后的危险比[HR]，2.09；95% CI，1.33-3.29）和既往梅毒（调整后的 HR，2.11；95% CI，1.39-3.20）是 HCV 血清转换的预测因素。
在 SHCS 中，IDU 中的 HCV 感染发病率下降，HET 中保持稳定，而 MSM 中在过去 13 年中增加了 18 倍。这些观察结果强调了需要加强对 HIV 感染的 MSM 中 HCV 的监测和预防。
