Favorable Socioeconomic Status and Recreational Polydrug Use Are Linked With Sexual Hepatitis C Virus Transmission Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men

Chen, Yun-Chi; Wiberg, Kjell; Hsieh, Yu Hsiang; Bansal, Arun; Bolzan, Philipe; Guy, Janelle; Maina, Erastus; Cox, Andrea L.; Thio, Chloe L.

doi:10.1093/ofid/ofw137

Cited by 14 publications

(9 citation statements)

References 36 publications

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“…Data on demographic, socioeconomic, clinical and behavioural characteristics were collected from 2003 to 2014 from the EMR database, using comprehensive medical chart reviews as previously described 28…”

Section: Methodsmentioning

confidence: 99%

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Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

et al. 2019

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ObjectivesLittle is known about the cascade of hepatitis C care among HIV/hepatitis C virus (HCV)-coinfected patients in community-based clinics. Thus, we analysed our data from the interferon era to understand the barriers to HCV treatment, which may help improve getting patients into treatment in the direct-acting antivirals era.DesignRetrospective cohort study.SettingFour HIV clinics of a multisite community health centre in the USA.Participants1935 HIV-infected men with >1 medical visit to the clinic between 2011 and 2013. Of them, 371 had chronic HCV and were included in the analysis for HCV care continuum during 2003–2014.Outcome measuresHCV treatment initiation was designated as the primary outcome for analysis. Multivariate logistic regression was performed to identify factors associated with HCV treatment initiation.ResultsAmong the 371 coinfected men, 57 (15%) initiated HCV treatment. Entering care before 2008 (adjusted OR [aOR, 3.89; 95% CI, 1.95 to 7.78), higher educational attainment (aOR, 3.20; 95% CI, 1.59 to 6.44), HCV genotype 1 versus non-1 (aOR, 0.21; 95% CI, 0.07 to 0.65) and HIV suppression (aOR, 2.13; 95% CI, 1.12 to 4.06) independently predicted treatment initiation. Stratification by entering care before or after 2008 demonstrated that higher educational attainment was the only factor independently associated with treatment uptake in both periods (aOR, 2.79; 95% CI, 1.13 to 6.88 and aOR, 4.10; 95% CI, 1.34 to 12.50, pre- and post-2008, respectively). Additional associated factors in those entering before 2008 included HCV genotype 1 versus non-1 (aOR, 0.09; 95% CI, 0.01 to 0.54) and HIV suppression (aOR, 2.35; 95% CI, 1.04 to 5.33).ConclusionsSome traditional barriers predicted HCV treatment initiation in those in care before 2008; however, the patients’ level of educational attainment remained an important factor even towards the end of the interferon era. Further studies will need to determine whether educational attainment persists as an important determinant for initiating direct-acting antiviral therapies.

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Section: Methodsmentioning

confidence: 99%

“…Those who reported past or current drug use were considered to have had a history of drug use. The definition of prevalent and incident HCV has been described previously 28. For the patients with incident HCV, the clinic visit of the first anti-HCV positive test was considered as the baseline visit.…”

Section: Methodsmentioning

confidence: 99%

Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

et al. 2019

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“…In addition to IVDU, re-emergence of an HCV epidemic between 2011–14 in a cohort of MSM in Baltimore, MD, was associated with favorable socioeconomic status, high-risk sexual behavior, and polysubstance use [47]. Sexual behavior as well as biologic factors, appear to contribute to the ongoing epidemic of HCV in HIV-infected MSM, including re-infection after DAA therapy [48, 49].…”

Section: Prevalence and Morbidity Associated With Co-infectionmentioning

confidence: 99%

Update in HIV–hepatitis C virus coinfection in the direct acting antiviral era

Meissner

2017

Current Opinion in Gastroenterology

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Purpose of Review Availability of direct acting antivirals (DAAs) that demonstrate remarkable clinical efficacy and safety has revolutionized the ability to treat chronic infection with hepatitis C virus (HCV). An equal measure of clinical success has now been achieved in persons co-infected with HCV and the human immunodeficiency virus (HIV), a historically harder to cure cohort with interferon-based therapy. Global goals include identifying all HIV/HCV-infected persons, gaining access to DAA-therapy, preventing de novo and re-infection, and managing the sequelae of chronic infection. This review will discuss advances in the field of HIV/HCV co-infection reported during the last 18 months, and will suggest areas for future investigation. Recent Findings An expanding body of literature has enhanced our understanding of the clinical and epidemiologic issues surrounding HIV/HCV co-infection. DAA therapy for HCV is highly efficacious in HIV/HCV co-infected persons if drug-drug interactions are appropriately considered. Summary Eradicating HCV infection in persons with HIV co-infection can be achieved safely and effectively with available DAAs. Economic and social approaches to enable access and delivery of curative HCV therapy to HIV-infected persons require continued research and resource allocation.

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“…In parallel, evidence from Europe, the United States, and Vancouver shows that sexual transmission can account for a substantial proportion of incident HCV infections among MSM [9,20,[22][23][24]. Socio-economic factors such as education and income can also influence the risk of acquiring HCV in this population [22,[25][26][27]. The impact of socio-economic factors and injecting and sexual behaviours on HCV transmission among MSM subgroups is contextdependent and, to date, there is little evidence of sexual transmission of HCV among MSM in Canada [15,16,20,28,29].…”

Section: Introductionmentioning

confidence: 99%

Trends in hepatitis C virus seroprevalence and associated risk factors among men who have sex with men in Montréal: results from three cross-sectional studies (2005, 2009, 2018)

Delaunay

Cox

Klein

et al. 2020

Preprint

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Introduction: To eliminate the hepatitis C virus (HCV) by 2030, Canada must adopt a micro-elimination approach targeting priority populations, including gay, bisexual, and other men who have sex with men (MSM). HCV prevalence and risk factors among MSM populations are context-dependent, and accurately describing these indicators at the local level is essential if we want to design appropriate, targeted prevention and treatment interventions. We aimed first to estimate and investigate temporal trends in HCV seroprevalence between 2005-2018 among Montreal MSM, and then to identify the socio-economic, behavioural, and biological factors associated with HCV exposure among this population. Methods: We used data from three bio-behavioural cross-sectional surveys conducted among Montreal MSM in 2005 (n=1,795), 2009 (n=1,258), and 2018 (n=1,086). To ensure comparability of seroprevalence estimates across time, we standardized the 2005 and 2009 time-location samples to the 2018 respondent-driven sample. Time trends overall and stratified by HIV status, history of injection drug use (IDU), and age were examined. Modified Poisson regression analyses with generalized estimating equations were used to identify factors associated with HCV seropositivity pooling all surveys. We used multiple imputation by chained equations for all missing values. Results: Standardized HCV seroprevalence among all MSM remained stable from 7% (95% confidence interval (CI): 3-10%) in 2005, to 8% (95%CI: 1-9%) in 2009, and 8% (95%CI: 4-11%) in 2018. This apparent stability hides diverging temporal trends in seroprevalence between age groups, with a decrease among MSM <30 years old, and an increase among MSM aged ≥45 years. History of IDU was the strongest predictor for HCV seropositivity (adjusted prevalence ratio: 8.0; 95%CI: 5.5-11.5), and no association was found between HCV seroprevalence and the sexual risk factors studied (condomless anal sex with men of serodiscordant/unknown HIV status, number of sexual partners, and group sex), nor with biological markers of syphilis. Conclusions: HCV seroprevalence remained stable among Montreal MSM between 2005-2018. Unlike other settings where HCV infection was strongly associated with sexual risk factors among MSM subgroups, IDU was the preeminent risk factor for HCV seropositivity. Understanding the intersection of IDU contexts, practices, and populations is essential to prevent HCV transmission among MSM.

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Favorable Socioeconomic Status and Recreational Polydrug Use Are Linked With Sexual Hepatitis C Virus Transmission Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men

Cited by 14 publications

References 36 publications

Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

Update in HIV–hepatitis C virus coinfection in the direct acting antiviral era

Trends in hepatitis C virus seroprevalence and associated risk factors among men who have sex with men in Montréal: results from three cross-sectional studies (2005, 2009, 2018)

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