Palma David, Alarcón Miguel, García de Olalla Patricia, Guerras Juan-Miguel, Pericas Carles, García Jorge, Barberá María Jesús, Ayerdi Oscar, Vera García Mar, Román-Urrestarazu Andrés, Belza María José, Rius Cristina
Consorcio de Investigación Biomédica en Red en Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
Servei d'Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain.
IJID Reg. 2023 Jul 7;8:95-104. doi: 10.1016/j.ijregi.2023.07.001. eCollection 2023 Sep.
Hepatitis C virus (HCV) has been recognized as a sexually transmitted infection (STI) in HIV-positive men who have sex with men (MSM), with an increased notification in HIV-negative MSM. The aim of this study was to determine the prevalence of HCV antibody and active HCV infection in HIV-negative gay, bisexual, and other MSM (GBMSM), and their characteristics, in Barcelona and Madrid, from March 2018 to March 2021.
Cross-sectional study conducted on 3548 HIV-undiagnosed GBMSM, across four HIV/STI testing centers. Respondents submitted an online, self-administered questionnaire after consultation, which collected information on sociodemographics, sexual health history, HCV knowledge, and substance consumption. Prevalence of HCV antibodies was determined by a reactive result in a rapid anti-HCV test or enzyme-linked immunosorbent assay (ELISA), while active HCV infection was determined by participants who were also positive on an HCV-RNA test. Crude and adjusted Poisson analyses with robust variance are presented for both prevalence and active infection.
In total, 97.6% of participants (n = 3463) were HIV-negative. Of those, 18 were found to have HCV antibodies (0.52%), of which nine (0.26%) were also HCV-RNA positive. Those with HCV antibodies were associated to have lived with an HCV (+) person (adjusted prevalence ratio [APR]: 7.84, [95% confidence interval: 2.50-24.53]), using injectable drugs for sex (APR: 6.92, [1.20-39.79]) and testing positive for an STI in the previous year (APR: 4.06, [1.09-15.12]). Presenting an active infection was strongly associated with a previous HCV diagnosis (APR: 100.82 [22.16-458.76]), sexualized injectable drug use (APR: 17.53 [2.70-113.76]), and sharing douching material (APR: 7.45, [2.12-25.95]).
Sexual practices with a higher risk of bleeding and sexualized drug use, particularly sexualized injectable drug use, were associated with higher rates of HCV diagnosis in GBMSM. Identifying these practices during consultation, contact tracing new cases and regularly testing those with a previous history of HCV, will facilitate HCV eradication.
丙型肝炎病毒（HCV）已被确认为男男性行为者（MSM）中人类免疫缺陷病毒（HIV）阳性者的性传播感染（STI），在HIV阴性的男男性行为者中报告率有所增加。本研究的目的是确定2018年3月至2021年3月期间巴塞罗那和马德里HIV阴性的男同性恋、双性恋及其他男男性行为者（GBMSM）中HCV抗体和活动性HCV感染的患病率及其特征。
在四个HIV/STI检测中心对3548名未诊断出HIV的GBMSM进行横断面研究。受访者在咨询后提交一份在线自填问卷，收集社会人口统计学、性健康史、HCV知识和物质使用情况等信息。HCV抗体的患病率通过快速抗HCV检测或酶联免疫吸附测定（ELISA）的反应性结果确定，而活动性HCV感染则由HCV-RNA检测也呈阳性的参与者确定。给出了患病率和活动性感染的粗泊松分析和调整后泊松分析以及稳健方差。
共有97.6%的参与者（n = 3463）HIV阴性。其中，18人被发现有HCV抗体（0.52%），其中9人（0.26%）HCV-RNA也呈阳性。有HCV抗体的人与HCV（+）感染者一起生活（调整患病率比[APR]：7.84，[95%置信区间：2.50 - 24.53]）、为性使用注射药物（APR：6.92，[1.20 - 39.79]）以及上一年STI检测呈阳性（APR：4.06，[1.09 - 15.12]）有关。出现活动性感染与先前的HCV诊断（APR：100.82 [22.16 - 458.76]）、性化注射药物使用（APR：17.53 [2.70 - 113.76]）以及共用冲洗材料（APR：7.45，[2.12 - 25.95]）密切相关。
具有较高出血风险的性行为和性化药物使用，特别是性化注射药物使用，与GBMSM中较高的HCV诊断率相关。在咨询过程中识别这些行为、追踪新病例的接触者并定期对有HCV既往史的人进行检测，将有助于消除HCV。
