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Sexually transmitted HCV common in MSM who are HIV positive

In a new meta-analysis, researchers from New York University found that sexually transmitted hepatitis C virus infection was common among HIV-positive men who have sex with men, according to published findings in AIDS.

“The purpose of our study was to explain why these outbreaks are occurring and understand whether the increase in reporting indicates a real trend,” Holly Hagan, PhD, professor at NYU College of Nursing and co-director of the Center for Drug Use and HIV Research (CDUHR), who leads the HCV Synthesis Project, said in a press release. “Understanding the causes and the magnitude of the problem will help identify subgroups for targeted intervention.”

Holly Hagan

Hagan and colleagues conducted a systematic review and meta-analysis to synthesize data characterizing sexually transmitted HCV in HIV-positive MSM. They analyzed data of more than 13,000 individuals followed in 17 different studies focusing on the mention of HCV seroconversion or on reinfection after successful HCV treatment in HIV-positive MSM who were not injecting drugs.

According to the research, 497 cases with HCV seroconversion over 93,100 person-years were found. The pooled incidence rate was 0.53 per 100 person-years (95% CI, 0.49-0.58).

Overall, HCV incidence rates ranged between 0 per 100 person-years to 1.4 per 100 person-years.

In 1991, the annual HCV incidence rate among HIV-positive MSM was 0.42 per 100 person-years. (95% CI, 0.23-0.77) and increased threefold by 2010 to 1.09 new infections per 100 person-years (95% CI, 0.73-1.61). By 2012, the estimate was 1.34, indicating the rate of increase was increasing (95% CI, 0.76-2.36).

“If the trend continues, current incidence of HCV infections may be as high as 1.92 new infections per 100 person-years — meaning, were we to follow 1,000 members of this cohort over the next year, we’d likely find that approximately 20 acquired HCV,” Hagan said.

Analyses showed that unprotected, receptive anal sex and sex while high on noninjected drugs were associated with an increased risk for infection. According to the release, one of the studies used found HCV reinfection was 20 times higher than the rate of initial infection in HIV-positive MSM, with 11 re-infections over 100 person-years.

Ashly E. Jordan, MPH, co-author and project director of the HCV Synthesis Project at CDUHR said in the release: “All of this data indicates the existence of a subgroup of HIV-positive MSM with recurring sexual exposure to HCV in whom the rates may begin to approach the risk of HCV infection among [people who inject drugs].”

The researchers concluded: “The high re-infection rates and the attributable risk analysis suggest the existence of a subset of HIV-positive MSM with recurring sexual exposure to HCV. Approaches to HCV control in this population will need to consider the changing epidemiology of HCV infection in MSM.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.