南加州男男性行为者中两项 HIV 暴露前预防依从性干预队列中丙型肝炎的发病率和患病率较低。

Low incidence and prevalence of hepatitis C in two cohorts of HIV pre-exposure prophylaxis adherence interventions in men who have sex with men in Southern California.

机构信息

Department of Medicine, University of California, San Diego, California, USA.

Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA.

出版信息

J Viral Hepat. 2022 Jul;29(7):529-535. doi: 10.1111/jvh.13678. Epub 2022 Apr 12.

DOI:10.1111/jvh.13678

PMID:35357767

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9908082/

Abstract

HIV pre-exposure prophylaxis (PrEP) has been associated with incident hepatitis C virus (HCV) infection in men who have sex with men (MSM) due to decreased condom use. We examined rates of HCV among MSM and transgender women at high-risk of HIV on PrEP in Southern California using data from two trials (NCT01761643 and NCT01781806). Five of 599 participants (0.84%, 95% CI, 0.27-1.93) had HCV antibodies detected at entry. Factors associated with HCV seropositivity included being older (p = .002) and lower education level (p < .001). HCV-positive participants had no reported cases of sexually transmitted infection (rectal, urethral or pharyngeal gonorrhoea and/or chlamydia) at entry while HCV-negative participants had a prevalence of 18% (95% CI, 15%-21%). There were no significant differences in substance use and sexual risk behaviour between HCV-positive and HCV-negative participants 1-3 months prior to entry. Among early PrEP adopters, incident HCV did not occur despite ongoing condomless intercourse. Screening intervals for HCV in MSM on PrEP should be led by a risk behaviour assessment.

摘要

HIV 暴露前预防 (PrEP) 与因减少使用安全套而导致的男男性行为者 (MSM) 中发生的丙型肝炎病毒 (HCV) 感染有关。我们利用两项试验（NCT01761643 和 NCT01781806）的数据，研究了南加州接受 PrEP 的 HIV 高危 MSM 和跨性别女性中 HCV 的发病率。在入组的 599 名参与者中，有 5 名（0.84%，95%CI，0.27-1.93）在入组时检测到 HCV 抗体。与 HCV 血清阳性相关的因素包括年龄较大（p=0.002）和教育程度较低（p<0.001）。HCV 阳性参与者在入组时没有报告任何性传播感染（直肠、尿道或咽部淋病和/或衣原体），而 HCV 阴性参与者的患病率为 18%（95%CI，15%-21%）。在入组前 1-3 个月，HCV 阳性和 HCV 阴性参与者在物质使用和性风险行为方面没有显著差异。在早期接受 PrEP 的人群中，尽管持续发生无保护性行为，但仍未发生 HCV 感染。接受 PrEP 的 MSM 中 HCV 的筛查间隔应根据风险行为评估来确定。