Department of Infectious Disease Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
Department of Infectious Disease Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
J Hepatol. 2017 Aug;67(2):255-262. doi: 10.1016/j.jhep.2017.03.038. Epub 2017 Apr 12.
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.
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.
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).
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.
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.
自 2000 年以来，感染艾滋病毒的男男性行为者（MSM）中的丙型肝炎病毒（HCV）发病率有所增加，尽管存在地区差异。我们旨在：1）估计 HIV 阳性 MSM 中 HCV 发病率的趋势；2）评估发病率与地理区域、年龄和与 HIV 相关的测量值之间的关联；3）评估从 HIV 血清转换到 HCV 感染的时间变化。
使用来自 MSM 的来自 CASCADE 合作的 HIV 血清转换日期准确估计的数据（1990-2014 年）。使用限制立方样条允许 HCV 发病率随时间的平滑变化趋势。使用泊松回归评估年份、年龄、CD4 计数（滞后）、HIV RNA（滞后）、地理区域和 HIV 感染阶段（近期与慢性）与 HCV 发病率的关联。
在 5941 名 MSM 中，337 人在随访期间感染了 HCV。1990 年 HCV 发病率为 0.7/1000 人年，2014 年上升至 18/1000 人年。近期的年份、较年轻的年龄、近期的 HIV 感染和较高的 HIV RNA 水平与 HCV 发病率显著相关，而 CD4 计数则不然。趋势因地理区域而异；虽然 HCV 发病率在西欧似乎已经稳定，在南欧保持稳定，但近年来在北欧仍在继续上升。从 HIV 到 HCV 感染的时间显著随时间缩短（p<0.001）。
近年来，HCV 继续在 HIV 阳性 MSM 中传播，但趋势因地理区域而异。需要采取干预措施降低 HCV 感染风险并提高早期诊断率。
丙型肝炎病毒感染继续在感染艾滋病毒的男男性行为者中传播，尤其是在年轻人中。然而，近年来欧洲各地区的趋势似乎有所不同。此外，HIV RNA 载量较高的男男性行为者更有可能感染丙型肝炎病毒。在最近的 HIV 感染期间，男男性行为者似乎面临更高的感染丙型肝炎病毒的风险。
