Prevalence and risk factors of hepatitis C in HIV‐negative homosexual men in Sydney, Australia

Jin, Fengyi; Prestage, Garrett; Kippax, Susan; Kaldor, John; Dore, Greg; Grulich, Andrew E.

doi:10.1111/j.1467-842x.2005.tb00246.x

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…Overall, our results correspond well with previously published prevalence estimates from Sydney (Health in Men study), where 7 out of 824 HIV-negative men aged 18-75 years (0.85%) tested positive for HCV antibodies [42]. As in the Australian study, we found no associations between HCV seropositivity and sexual practices that could have plausibly facilitated blood exposure, such as UAI and fisting.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of hepatitis C in a Swiss sample of men who have sex with men: whom to screen for HCV infection?

Schmidt

Falcato

Zahno³

et al. 2014

BMC Public Health

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BackgroundWhile the numbers of hepatitis-C-virus (HCV) infections among men who have sex with men (MSM) who are co-infected with the human immunodeficiency virus (HIV) are on the rise, with vast evidence for sexual transmission of HCV in this population, concerns have also been raised regarding sexual HCV-transmission among MSM without HIV infection. Therefore, the aim of this study was to estimate the prevalence of hepatitis C among MSM without HIV diagnosis in Zurich (Switzerland).MethodsParticipants were recruited from a gay health centre and various locations such as dark rooms, saunas and cruising areas in Zurich. Participants self-completed a questionnaire assessing known and suspected risk factors for HCV-infection, and provided a blood sample for detection of past (antibodies) and present (core antigen, RNA) infections with HCV.ResultsIn total, 840 MSM aged 17-79 (median: 33 years) underwent HCV-testing and completed the questionnaire, among whom 19 reported living with HIV. Overall, seven tested positive for HCV-antibodies, and two were also positive for HCV core antigen and HCV-RNA–these two were immigrants, one from a country where HCV is endemic. None of the seven were aware of their infection. The seroprevalence of hepatitis C among the 821 non-HIV-diagnosed MSM was 0.37% (95%-CI: 0.12-1.69%), and one man harboured replicating virus (0.12%; 0.02-0.69%), resulting in a number needed to test of 821 to detect one active infection. Significant univariable associations of lifetime HCV-infection were found with known HIV-diagnosis (OR=72.7), being tattooed (OR=10.4), non-injection use of cocaine/amphetamines (OR=8.8), and non-Swiss origin (OR=8.5). For MSM without HIV-diagnosis, the only variable marginally associated with positive HCV-serostatus was being tattooed (OR=8.3). No significant associations were observed with reported injection drug use, unprotected anal intercourse, sexual practices that may lead to mucosal trauma, or proxy measures for group sex and lesion-prone STIs.ConclusionsOur findings suggest that in Switzerland, hepatitis C among MSM without diagnosed HIV is not more prevalent than in the general population. We found no evidence of elevated rates of sexual transmission of HCV among MSM without HIV-infection. Therefore, we currently see no reason for promoting HCV-testing among all MSM in Switzerland.

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Section: Discussionsupporting

confidence: 91%

Prevalence of hepatitis C in a Swiss sample of men who have sex with men: whom to screen for HCV infection?

Schmidt

Falcato

Zahno³

et al. 2014

BMC Public Health

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“…However, persons screened were HIV-negative MSM, a subpopulation almost unaffected by the current HCV outbreaks [29]. Moreover, HCV screening stopped before the onset of the HCV outbreaks reported in Europe.…”

Section: Discussionmentioning

confidence: 97%

Increase in HCV Incidence among Men Who Have Sex with Men in Amsterdam Most Likely Caused by Sexual Transmission

Laar¹,

Bij²,

et al. 2007

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We retrospectively screened 1836 men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (1984-2003) for hepatitis C virus (HCV) antibodies. HCV incidence was 0.18/100 person-years (PY) in human immunodeficiency virus (HIV)-positive MSM (8/4408 PY [95% confidence interval {CI}, 0.08-0.36]) but was 0/100 PY in MSM without HIV (0/7807 PY [95% CI, 0.00-0.05]). After 2000, HCV incidence among HIV-positive men increased 10-fold to 0.87/100 PY (5/572 PY [95% CI, 0.28-2.03]). Additional hospital cases (n=34) showed that MSM in Amsterdam who acquired HCV infection after 2000 reported high rates of ulcerative sexually transmitted infections (59%) and rough sexual techniques (56%), denied injection drug use, and were infected mainly with the difficult-to-treat HCV genotypes 1 (56%) and 4 (36%). Phylogenetic analysis showed 3 monophyletic clusters of MSM-specific HCV strains. The emergence of an MSM-specific transmission network suggests that HIV-positive MSM with high-risk sexual behaviors are at risk for sexually acquired HCV. Targeted prevention and routine HCV screening among HIV-positive MSM is needed to deter the spread of HCV.

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“…Large longitudinal studies of HCV-serodiscordant heterosexual couples have not yielded significant evidence for sexual transmission; so condom use for the prevention of HCV transmission has not been recommended for vaginal intercourse between monogamous HCV-serodiscordant sexual partners [33]–[36]. Large cohort studies of HIV-negative MSM showed that sexual behaviour, including unprotected anal intercourse (UAI), was not associated with prevalent HCV infections [37]; and those HCV seroconversions rarely observed among MSM without HIV infection could typically be attributed to injection drug use [10], [38]. Certain sexual practices involving trauma of the rectal mucosa have been discussed as relevant risk factors among MSM [13], [39].…”

Section: Introductionmentioning

confidence: 99%

Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control Study

et al. 2011

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ObjectivesTo identify risk factors for hepatitis C among HIV-positive men who have sex with men (MSM), focusing on potential sexual, nosocomial, and other non-sexual determinants.BackgroundOutbreaks of hepatitis C virus (HCV) infections among HIV-positive MSM have been reported by clinicians in post-industrialized countries since 2000. The sexual acquisition of HCV by gay men who are HIV positive is not, however, fully understood.MethodsBetween 2006 and 2008, a case-control study was embedded into a behavioural survey of MSM in Germany. Cases were HIV-positive and acutely HCV-co-infected, with no history of injection drug use. HIV-positive MSM without known HCV infection, matched for age group, served as controls. The HCV-serostatus of controls was assessed by serological testing of dried blood specimens. Univariable and multivariable regression analyses were used to identify factors independently associated with HCV-co-infection.Results34 cases and 67 controls were included. Sex-associated rectal bleeding, receptive fisting and snorting cocaine/amphetamines, combined with group sex, were independently associated with case status. Among cases, surgical interventions overlapped with sex-associated rectal bleeding.ConclusionsSexual practices leading to rectal bleeding, and snorting drugs in settings of increased HCV-prevalence are risk factors for acute hepatitis C. We suggest that sharing snorting equipment as well as sharing sexual partners might be modes of sexual transmission. Condoms and gloves may not provide adequate protection if they are contaminated with blood. Public health interventions for HIV-positive gay men should address the role of blood in sexual risk behaviour. Further research is needed into the interplay of proctosurgery and sex-associated rectal bleeding.

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Prevalence and risk factors of hepatitis C in HIV‐negative homosexual men in Sydney, Australia

Abstract: Objective: To determine the prevalence and risk factors for hepatitis C (HCV) in HIV-negative homosexual men in Sydney. Methods

Cited by 9 publications

References 14 publications

Prevalence of hepatitis C in a Swiss sample of men who have sex with men: whom to screen for HCV infection?

Prevalence of hepatitis C in a Swiss sample of men who have sex with men: whom to screen for HCV infection?

Increase in HCV Incidence among Men Who Have Sex with Men in Amsterdam Most Likely Caused by Sexual Transmission

Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control Study

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