Hepatitis C infection among men who have sex with men living with HIV in New York City, 2000–2015

Abstract

ObjectivesTo calculate the rate of hepatitis C virus (HCV) among HIV-infected men who have sex with men (MSM) with no reported history of injection drug use (IDU), and to assess whether disparities exist in HIV/HCV coinfection by race/ethnicity and neighbourhood poverty level within this population in New York City.MethodsHIV-positive men who reported sex with men and did not report IDU at the time of HIV diagnosis, diagnosed through 2015 and alive as of 2000, were matched to people with HCV first reported to the New York City Department of Health and Mental Hygiene between 2000 and 2015. Those with HCV reported before or within 90 days of HIV infection were excluded. A multivariable Cox proportional hazards model was fit to compare the association between HCV diagnosis, race/ethnicity and neighbourhood poverty level.ResultsFrom 2000 to 2015, 54 488 non-IDU MSM were diagnosed with HIV, of whom 2762 (5.1%) were diagnosed with HCV after HIV diagnosis, yielding an overall age-adjusted HCV diagnosis rate of 512 per 100 000 person-years. HIV/HCV coinfection was significantly higher among non-Latino blacks (adjusted HR (aHR)=1.24, 95% CI 1.11 to 1.40) compared with non-Latino whites and among persons living in high-poverty neighbourhoods compared with those in low-poverty neighbourhoods (aHR=1.17, 95% CI 1.01 to 1.35) after stratification by year of HIV diagnosis.ConclusionDisparities in HIV/HCV coinfection among HIV-positive MSM were observed by race/ethnicity and neighbourhood poverty level. Routine HCV screening is recommended for people infected with HIV. People coinfected with HIV and HCV should be linked to HCV care, treated and cured to reduce morbidity and mortality, and to avoid ongoing HCV transmission.

Prevalence of hepatitis B and C infections among HIV‐positive men who have sex with men: A systematic review and meta‐analysis

“…Fifty‐six studies fulfilled the inclusion criteria, as shown in Table 1 , comprising a total of 309203 MSM PLHIV. Switzerland contributed five studies, 18 , 20 , 37 , 38 , 39 United States had 11 studies, 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 Spain had four studies, 51 , 52 , 53 , 54 Netherlands had four studies, 55 , 56 , 57 , 58 three studies were from France, 17 , 59 , 60 six studies were from Taiwan, 22 , 61 , 62 , 63 , 64 , 65 eight studies were from United Kingdom, 19 , 21 , 23 , 25 , 66 , 67 , 68 , 69 two studies were from Europe, 70 , 71 two studies from Japan, 24 , 72 two studies from Australia. 73 , 74 One study each were from Belgium, 75 …”

Patterns and correlates of hepatitis C virus phylogenetic clustering among people living with HIV in Australia in the direct‐acting antiviral era: A molecular epidemiology study among participants in the CEASE cohort

“… 11 Because of the possible high degree of connectivity in these networks, the potential for sustained transmission, including HCV reinfection after treatment, has been flagged as a factor that may undermine HCV microelimination efforts. 12 , 13 , 14 , 15 …”

“…For example, populations with low levels of phylogenetic clustering could indicate that loosely connected sexual or drug use networks exist. Previous studies have found that HCV acquisition is associated with younger age, 24 female sex (vs. male sex), 25 recent injection drug use, 26 homelessness, 27 material deprivation, 14 and sexual behavior such as serosorting 28 or chemsex. 29 Investigation into the extent of HCV phylogenetic clustering and patterns and correlates of clustering with these previously identified factors is needed.…”

“…11 Because of the possible high degree of connectivity in these networks, the potential for sustained transmission, including HCV reinfection after treatment, has been flagged as a factor that may undermine HCV microelimination efforts. [12][13][14][15] Molecular epidemiologic studies have begun to shed light on drivers behind the transmission of HCV that would not be possible to elucidate using either phylogenetic or epidemiologic techniques in isolation. In the setting of urban people who inject drugs who are living with HCV infection, it has been demonstrated that phylogenetic clustering of HCV is associated with social injecting networks, suggesting that having closely related viruses could indicate putative transmission links between hosts.…”

“…Given the high proportion of HCV phylogenetic clustering among gay and bisexual men living with HIV, both in Australia and internationally, 9,10 it has been hypothesized that HCV is transmitted within highly connected, but separate, sexual and drug use networks 11 . Because of the possible high degree of connectivity in these networks, the potential for sustained transmission, including HCV reinfection after treatment, has been flagged as a factor that may undermine HCV microelimination efforts 12–15 …”