Comparison of risk factors in HIV-infected men who have sex with men, coinfected or not with hepatitis C virus (ANRS VESPA2 French cross-sectional national survey)

Abstract

Objectives HIV-infected men who have sex with men (HIV-MSM) are at high risk of hepatitis C virus (HCV) infection. This study aimed to compare risk factors between HIV-MSM coinfected with HCV and those who are not, in a national representative survey conducted in France. Methods The ANRS VESPA2 survey (April 2011-January 2012) collected sociodemographic and behavioural data (through face-to-face administered questionnaires) as well as medical data ( physician questionnaire) among 3022 HIV-infected adults recruited in 73 French HIV hospital departments. We identified behavioural correlates of HCV coinfection among sexually active HIV-MSM who participated in VESPA2 (logistic regression models). Results Ninety-three of the 1037 HIV-MSM of the study population (8.9%) were coinfected with HCV. The following risk factors were independently associated with HCV coinfection, after adjustment for age and time since HIV diagnosis: current or past injecting drug use, having had at least 20 male sexual partners during the previous 12 months, reporting inconsistent condom use during anal sex with casual partners, and attending sex parties. Individuals reporting at least three sexual risk factors were at the highest risk of being coinfected with HCV (OR (95% CI): 22.86 (9.74; 53.62), p<0.0001). Conclusions HIV-MSM reporting several sexual risk factors should be sensitised to risk-reduction behaviours to avoid HCV transmission to sexual partners, and infection or reinfection with HCV.

Risk Factors for Hepatitis C Virus Reinfection After Sustained Virologic Response in Patients Coinfected With HIV

“…We categorized patients according to principal risk factors for incident HCV infection in HIV-coinfected persons (injection drug use [IDU] and high-risk sexual activity in MSM [15, 16]) using information that could be readily obtained by clinicians. Recent high-frequency IDU was defined as any self-reported use of injection cocaine or methamphetamines in the last 6 months because these drugs are associated with multiple injections per day and a high degree of risk-taking behavior [17].…”

United Kingdom National Guideline on the Management of the viral hepatitides A, B and C 2015

“…136 LGV or in situations of traumatic anal sex, fisting and sharing of sex toys. [138][139][140] . Since September 1991 all donated blood in the UK has been screened for HCV.…”

“…In patients with chronic infection, sexual transmission should be discussed. It seems likely that if condoms are used consistently then sexual transmission will be avoided, but given the very low rates of transmission outside of HIV co-infection[136][137][138][139][140][141][142] (see above), monogamous partners may choose not to use them. Sexual contacts with HIV should be advised of the risk of sexual transmission, with regular testing and condom use encouraged (1D) [136][137][138][139][140][141][142].…”

Thirty Years of Research on Gay Men and HIV Prevention in France: A Narrative Review of the Literature

“…During this period, new research emerged on subjects such as barebacking (Girard, 2013;Rojas-Castro et al, 2012;Rojas Castro, & Girard, 2015), co-infection with HIV and hepatitis C (Le Talec, 2013;Marcellin et al, 2015), as well as gay men and their relationship to pornography (Vörös, 2014), drug use (Fournier & Escot, 2010;Gaissad, 2013), and strategies of risk reduction Velter, Bouyssou-Michel, Arnaud, & Semaille, 2009). This period also saw the development of seminal research on Africa and migrations of "men who have sex with men" between African countries and France (Awondo, Geschierer & Reid, 2012;Broqua, 2013;Gning, 2013;Wade et al, 2010).…”