Apers L, Koole O, Bottieau E, Vandenbruaene M, Ophoff D, Van Esbroeck M, Crucitti T, Florence E
Acta Clin Belg. 2013 Nov-Dec;68(6):421-6. doi: 10.2143/ACB.3315.
Recurrent Sexually Transmitted Infections (STIs) are an indication of unsafe sexual practices and may be associated with HCV-infection among HIV-positive men who have sex with men. In a retrospective study we analysed the laboratory data of 99 HIV-positive MSM who acquired HCV during the observation period (cases) and 176 HIV-positive MSM who remained HCV negative during the observation period (controls), all followed at the HIV/STI-clinic in Antwerp, Belgium. All laboratory confirmed STI-episodes were recorded since the date of first consultation at our clinic, until the date of HCV-diagnosis of the cases. The HCV incidence varied between 0.24 (2001) and 1.36 (2011) new cases per hundred person-years, with a peak of 2.93 new cases per hundred person-years in 2009. The number of STI-episodes per person-year follow-up was significantly higher for the cases as compared to the controls for syphilis, non-LGV and LGV Chlamydia infections (p < 0.005). When considering the incidence of STIs that occurred 1 year prior to HCV conversion, all laboratory confirmed STIs remained more frequent among cases, but only the difference in syphilis incidence was statistically significant (p < 0.01). Recurrent STIs among HIV positive MSM should be considered as a behavioural and biological risk factor for acquiring HCV and should lead to intensified screening for HCV and counselling of the patient.
复发性性传播感染(STIs)表明存在不安全的性行为,并且可能与男男性行为者(MSM)中的艾滋病毒(HIV)感染者感染丙型肝炎病毒(HCV)有关。在一项回顾性研究中,我们分析了99名在观察期内感染HCV的HIV阳性MSM(病例组)和176名在观察期内HCV仍为阴性的HIV阳性MSM(对照组)的实验室数据,所有研究对象均在比利时安特卫普的HIV/性传播感染诊所接受随访。自首次在我们诊所就诊之日起,记录所有实验室确诊的性传播感染发作情况,直至病例组的HCV诊断日期。HCV发病率在每100人年0.24例(2001年)至1.36例(2011年)之间变化,2009年达到每100人年2.93例的峰值。与对照组相比,病例组梅毒、非淋巴肉芽肿性(non-LGV)和淋巴肉芽肿性(LGV)衣原体感染的每人年随访期内性传播感染发作次数显著更高(p < 0.005)。在考虑HCV血清转化前1年发生的性传播感染发病率时,所有实验室确诊的性传播感染在病例组中仍然更为常见,但只有梅毒发病率的差异具有统计学意义(p < 0.01)。HIV阳性MSM中的复发性性传播感染应被视为感染HCV的行为和生物学危险因素,应加强对HCV的筛查并对患者进行咨询。