Risk factors for HCV transmission in HIV-positive men who have sex with men in México

Abstract

Purpose In the last two decades transmission of hepatitis C virus (HCV) in HIV positive men who have sex with men (MSM) has been reported globally. Chemsex and specific sexual practices have been identified as risk factors. Our study aimed to identify risk factors for HCV transmission in MSM living with HIV attending in Mexico. Methods We conducted a case-control study from April to December 2019 at the Hospital de Infectología “La Raza” National Medical Center, in Mexico City. A case was defined as an HIV-infected MSM with positive HCV-antibody test. For each case, 3 controls were included, defined as HIV infected MSM with negative HCV-antibody test. A self-questionnaire covering sexual practices and other risk factors for HCV transmission was applied. Bivariate analysis was performed to obtain odds ratio (OR) using Chi-square test. Independent risk factors were identified in a subsequent analysis performing a logistic regression model. Results A total of 324 patients participated in the study, 81 cases and 243 controls. Median age was 30.5 years (IQR: 18–52) and 28.8 years (IQR: 21–45) in the case and control group, respectively. Most prevalent HCV genotype was 1a (79%). In the logistic regression model, sharing straw during cocaine inhalation (OR: 9.03; 95% CI; 1.35–13.52; P = 0.003), sharing sex toys (OR: 17.53, 95% CI; 6.85–44.86; P = 0.002), and ethyl chloride use for chemsex (OR: 2.26; 95% CI; 1.29–5.56; P = 0.037) were significant risk factors for HCV infection. Conclusion This study identifies risk factors for HCV transmission in Mexico in HIV positive MSM in congruence with the findings of many studies performed worldwide. This is the first study that indicates a possible association between ethyl chloride use in chemsex and HCV infection. Assessment of local populations for risk factors for HCV transmission may help to develop specifically targeted behavioral interventions to reduce HCV transmission.

Still trouble with bleeding: Risk factors for HCV transmission in men who have sex with men and behavioural trajectories from 2019 to 2021

“…Vanhommerig et al identified independent associations between HCV acquisition and factors such as sharing sex toys, unprotected fisting, sharing straws for drug use, mucosal disruption (ulcerative STIs) and receptive condomless anal intercourse in HIV‐diagnosed MSM in the Netherlands [15]. Mata‐Marín et al found similar associations in a study of HIV‐diagnosed MSM from Mexico, including sharing straws during cocaine use, sharing sex toys and chemsex [8]. Huang et al in Taiwan linked HCV viraemia among HIV‐positive MSM to recreational drug use, group sex and condomless receptive anal intercourse [25].…”

“…Others have suggested that among MSM, a combination of shared drug utensils, rectal mucosal trauma from receptive anal intercourse, ulcerative sexually transmitted infections (STIs), rectal douching [8,9] and contamination of shared fomites (dildos, condoms, gloves, lubricant, and, more broadly, penises and fists) can indirectly transmit HCV from one person's traumatized rectal mucosa to another's [10,11].…”

Hepatitis C Epidemiology: Insights from a Comprehensive Cohort Study in ASST Melegnano and Martesana, Lombardia Region, Northern Italy

“…Sexual transmission is also a recognized risk factor. Vertical transmission from infected mother to child is also possible [ 1 , 2 , 3 , 7 ]. In 2019, hepatitis C resulted in an estimated 12,696 deaths.…”

ChemsexPH: The association between chemsex, HIV status and adherence to antiretroviral therapy among men who have sex with men in the Philippines

“…Chemsex engagement involves psychotropic drug use to enhance sexual experiences [ 4 , 5 ] and the subculture of “slamsex” involves intravenous drug injection—both often influenced by sensation‐seeking behaviours [ 6 , 7 ] and pose increased risks of bloodborne virus transmission [ 8 ]. Common substances used in chemsex include crystal methamphetamine (“shabu” in the Philippines) and gamma hydroxybutyrate [ 9 , 10 , 11 ].…”