Trends in hepatitis C virus seroprevalence and associated risk factors among men who have sex with men in Montréal: results from three cross-sectional studies (2005, 2009, 2018)

Abstract

Introduction: To eliminate the hepatitis C virus (HCV) by 2030, Canada must adopt a micro-elimination approach targeting priority populations, including gay, bisexual, and other men who have sex with men (MSM). HCV prevalence and risk factors among MSM populations are context-dependent, and accurately describing these indicators at the local level is essential if we want to design appropriate, targeted prevention and treatment interventions. We aimed first to estimate and investigate temporal trends in HCV seroprevalence between 2005-2018 among Montreal MSM, and then to identify the socio-economic, behavioural, and biological factors associated with HCV exposure among this population. Methods: We used data from three bio-behavioural cross-sectional surveys conducted among Montreal MSM in 2005 (n=1,795), 2009 (n=1,258), and 2018 (n=1,086). To ensure comparability of seroprevalence estimates across time, we standardized the 2005 and 2009 time-location samples to the 2018 respondent-driven sample. Time trends overall and stratified by HIV status, history of injection drug use (IDU), and age were examined. Modified Poisson regression analyses with generalized estimating equations were used to identify factors associated with HCV seropositivity pooling all surveys. We used multiple imputation by chained equations for all missing values. Results: Standardized HCV seroprevalence among all MSM remained stable from 7% (95% confidence interval (CI): 3-10%) in 2005, to 8% (95%CI: 1-9%) in 2009, and 8% (95%CI: 4-11%) in 2018. This apparent stability hides diverging temporal trends in seroprevalence between age groups, with a decrease among MSM <30 years old, and an increase among MSM aged ≥45 years. History of IDU was the strongest predictor for HCV seropositivity (adjusted prevalence ratio: 8.0; 95%CI: 5.5-11.5), and no association was found between HCV seroprevalence and the sexual risk factors studied (condomless anal sex with men of serodiscordant/unknown HIV status, number of sexual partners, and group sex), nor with biological markers of syphilis. Conclusions: HCV seroprevalence remained stable among Montreal MSM between 2005-2018. Unlike other settings where HCV infection was strongly associated with sexual risk factors among MSM subgroups, IDU was the preeminent risk factor for HCV seropositivity. Understanding the intersection of IDU contexts, practices, and populations is essential to prevent HCV transmission among MSM.

Past dynamics of HIV transmission among men who have sex with men in Montréal, Canada: a mathematical modeling study

“…Data from the peer-reviewed and grey literature, and individual-level data from the two cross-sectional Argus surveys (2005; n = 1957 and 2008; n = 1873), the Engage cohort (2017; n = 1179, 2018; n = 887, 2019; n = 850), and the L'Actuel PrEP Cohort (2013-2019; n = 2746) studies were analyzed to identify temporal trends in sexual behaviors and HIV interventions uptake. Details on the studies can be found elsewhere [20][21][22][23][24][25][26]. Briefly, the Argus surveys used venue-based convenience sampling to recruit gbMSM aged 18 + years from the island of Montréal who reported sex with another man during their lifetime.…”

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: hepatites virais

“…De estos, 168.036 (25%) estaban relacionados con la hepatitis A, 247.890 (36,8%) con la hepatitis B, 253.307 (37,6%) con la hepatitis C y 4.156 (0,6%) con la hepatitis D. 7 Geraldo Duarte y colaboradores miembro superior en la vagina o ano, sexo en grupo, compartir objetos sexuales y sexo bajo la influencia de drogas psicoactivas), constituyen un grupo importante de situaciones y factores que facilitan la transmisión del VHC. 23,24 Si bien la transmisión del VHC es menor en personas con hábitos heterosexuales, aumenta entre quienes tienen un gran número de parejas sexuales o practican sexo anal. 21…”

“…6,63 Las orientaciones y cuidados con las personas usuarias de drogas ilícitas y las que practican actividad sexual sin protección adecuada son las estrategias que potencialmente pueden traer mejores resultados en la reducción de las infecciones por el VHC. 6,[21][22][23][24] Otra forma de control de la infección por el VHC es la terapia antiviral de acción directa contra el virus, cuyo éxito amplió la discusión sobre el tratamiento como estrategia para la prevención de la enfermedad. 64…”

Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis

“…It is known that HCV sexual transmission is more frequent among men who have sex with men 22 . As for other sexually transmitted infections, the presence of other STI, ulcerative or not, for example, human immunodeficiency virus (HIV), and unprotected sexual practices, especially those posing the greater risk of mucous bleeding (anal sex without lubricant, upper limb introduction in the vagina or anus, group sex, sexual object sharing, and sex under psychoactive drug effects), are a significant group of situations and factors facilitating HCV transmission 23 , 24 . Although HCV transmission is lower in people with heterosexual habits, and it is higher among those with a large number of sex partners or who perform anal sex 21 .…”