Incidence of Hepatitis-C among HIV infected men who have sex with men (MSM) attending a sexual health service: a cohort study.

Published: February 3, 2011

ABSTRACT:

BACKGROUND: We aimed to determine the incidence of Hepatitis C (HCV) infection among HIV-infected men who have sex with men (MSM) attending a Sexual Health Centre.

METHODS: A retrospective cohort study was carried out among HIV infected MSM seen at least once between February 2002 and March 2010. The analysis was restricted to MSM who had had a negative HCV antibody test at least 6 months after their diagnosis for HIV. Duration of follow up was taken from the date of HIV diagnosis to the first positive or last negative HCV antibody test.

RESULTS: During the time 1445 HIV infected men attended the clinic of whom 1065 (74%) were MSM. Of these, 869 (82%) were tested for HCV at any time after HIV diagnosis. Of these 869, 620 (69%) tested HCV negative at least 6 months after their HIV diagnosis. These 620 men had a mean age of 34 years (range 17-72) at HIV diagnosis and a total of 4,359 person years (PY) of follow up. There were 40 incident cases of hepatitis C, of which 16 were among intravenous drug users and 24 among non intravenous drug users. The overall incidence of HCV among HIV infected MSM was 0.9/100 PY (95% CI 0.6 -1.2). The incidence among HIV infected intravenous drug users was 4.7/100 PY (95% CI 2.7-7.5) while the incidence among HIV infected non-intravenous drug users was 0.6/100 PY (95% CI 0.4-0.8) (hazard ratio of 8.7 and 95% CI 4.6-16.6, P<0.001). The majority (78%) were tested for HCV because of they developed abnormal liver transaminases (n=31) or hepatitis symptoms (n=2), while others (n = 7) were identified through routine HCV testing.

CONCLUSION: A considerable proportion of HIV positive MSM who did not use intravenous drugs contracted hepatitis C, presumably via sexual transmission and the main trigger for investigation was abnormal liver transaminases.

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