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.
Methods
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.
Results
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).
Conclusions
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.
Lay summary
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.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: April 13, 2017
Accepted:
March 30,
2017
Received in revised form:
January 30,
2017
Received:
August 23,
2016
Identification
Copyright
© 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
