Ghisla Virginia, Scherrer Alexandra U, Nicca Dunja, Braun Dominique L, Fehr Jan S
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
Infection. 2017 Jun;45(3):309-321. doi: 10.1007/s15010-016-0975-y. Epub 2016 Dec 22.
There is a need for systematic reviews and meta-analyses to synthesize the epidemiology, and the riskfactors for hepatitis C virus (HCV) among HIV-coinfected and HIV negative men who have sex with men (MSM).
A meta-analysis of 28 studies was carried out by pooling HCV incidence data of HIV-coinfected and HIV negative MSM. Differences in incidence outcome depending on the prospective or retrospective nature of the individual studies were investigated.
The pooled incidence of HCV in MSM was 6.3 per 1000 person-years (95% CI 5.0-7.5). The overall estimated incidence was 19-fold higher in HIV positive compared to HIV negative MSM living in resource-rich countries. This result was confirmed when the analysis was restricted to high-quality studies. Factors associated with an increased risk for incident HCV included behavioural factors (sexual risk behaviour and recreational drug use) as well as biological characteristics (HIV coinfection and a recent history of syphilis).
In conclusion, incident HCV predominantly affects HIV positive MSM. The incidence rate varied largely between studies, factors such as study design might play an important role.
需要进行系统评价和荟萃分析,以综合合并感染人类免疫缺陷病毒(HIV)和未感染HIV的男男性行为者(MSM)中丙型肝炎病毒(HCV)的流行病学及危险因素。
通过汇总合并感染HIV和未感染HIV的MSM的HCV发病率数据,对28项研究进行荟萃分析。研究了根据个体研究的前瞻性或回顾性性质,发病率结果的差异。
MSM中HCV的合并发病率为每1000人年6.3例(95%可信区间5.0-7.5)。生活在资源丰富国家的HIV阳性MSM的总体估计发病率比HIV阴性MSM高19倍。当分析仅限于高质量研究时,这一结果得到了证实。与HCV感染风险增加相关的因素包括行为因素(性风险行为和使用消遣性药物)以及生物学特征(合并感染HIV和近期梅毒病史)。
总之,新发HCV主要影响HIV阳性MSM。研究之间的发病率差异很大,研究设计等因素可能起重要作用。