SEARCH, The Thai Red Cross AIDS Research Center, Bangkok, Thailand.
The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
J Acquir Immune Defic Syndr. 2020 Aug 1;84(4):331-335. doi: 10.1097/QAI.0000000000002356.
Increased rates of hepatitis C virus (HCV) infection among HIV-infected men who have sex with men (MSM) and who deny injecting drugs have been reported in resource-rich settings.
We measured HCV prevalence and incidence in a predominantly MSM cohort with acute HIV infection in Bangkok, Thailand.
In 2009-2018, participants with acute HIV infection were enrolled into the SEARCH010/RV254 cohort. HCV antibody was measured at enrollment and at least once annually. Infection was confirmed with HCV RNA. Risk factors for HCV were analyzed by proportional hazards regression, with hazard ratios (HRs) calculated in a multivariable model.
Of 573 participants, 94% were MSM, with a median age of 26 years (range 18-70 years). The prevalence of HCV antibody was 9 of the 573, or 1.6% [95% confidence interval (CI): 0.7% to 3.0%]. In 1883 person-years (PY) of follow-up, 39 incident cases were identified (20.7 per 1000 PY, 95% CI: 15.1 to 28.3). All incident cases were identified from 2014 onward, and incidence rose from a range of 7.5-11.4 per 1000 PY between 2014 and 2016 to 44.8 per 1000 PY in 2018 (P = 0.001). Most cases (97.4%) were MSM and denied injecting drugs (37 of the 39, 94.5%). In multivariate analysis, methamphetamine use [adjusted HR 2.33 (95% CI: 1.13 to 4.8), P = 0.022], group sex [adjusted HR 2.54 (95% CI: 1.26 to 5.12), P = 0.009], and a history of positive Treponema pallidum hemagglutination or rapid plasma reagin [adjusted HR 2.43 (95% CI: 1.22 to 4.85), P = 0.012] were significantly associated with incident HCV.
We report an HCV epidemic among this cohort of HIV-infected Bangkok-based MSM. Access to timely HCV diagnosis and treatment is needed to prevent morbidity and to decrease onward transmission.
在资源丰富的地区，有报道称，感染艾滋病毒的男男性行为者（MSM）中丙型肝炎病毒（HCV）感染率上升，且这些人否认有注射毒品史。
我们在泰国曼谷的一个急性 HIV 感染的主要 MSM 队列中测量了 HCV 的流行率和发病率。
在 2009 年至 2018 年期间，患有急性 HIV 感染的参与者被纳入 SEARCH010/RV254 队列。在入组时和至少每年一次时检测 HCV 抗体。通过 HCV RNA 确认感染。通过比例风险回归分析 HCV 的危险因素，并用多变量模型计算风险比（HR）。
在 573 名参与者中，94%为 MSM，中位年龄为 26 岁（18-70 岁）。573 名参与者中，HCV 抗体阳性者 9 例，占 1.6%[95%置信区间（CI）：0.7%至 3.0%]。在 1883 人年（PY）的随访中，共发现 39 例新发病例（20.7/1000PY，95%CI：15.1 至 28.3）。所有新发病例均在 2014 年以后发现，发病率从 2014 年至 2016 年的 7.5-11.4/1000PY 上升至 2018 年的 44.8/1000PY（P=0.001）。大多数病例（97.4%）为 MSM 且否认注射毒品史（37 例，94.5%）。多变量分析显示，使用甲基苯丙胺[校正 HR 2.33（95%CI：1.13 至 4.8），P=0.022]、群交[校正 HR 2.54（95%CI：1.26 至 5.12），P=0.009]和梅毒螺旋体血凝试验或快速血浆反应素阳性史[校正 HR 2.43（95%CI：1.22 至 4.85），P=0.012]与 HCV 感染显著相关。
我们报告了曼谷 HIV 感染的 MSM 队列中 HCV 流行情况。需要及时诊断和治疗 HCV，以预防发病和减少传播。
