Hepatitis C Virus Reinfection Among Men Who Have Sex With Men With HIV in New York City.
condomless receptive anal intercourse (CRAI)
ejaculation of semen into rectum
sexual networks
sexualized drug use
transmission
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
18 Jul 2024
18 Jul 2024
Historique:
received:
14
03
2024
medline:
18
7
2024
pubmed:
18
7
2024
entrez:
18
7
2024
Statut:
aheadofprint
Résumé
Hepatitis C virus (HCV) reinfection rates are substantially higher than primary infection rates among men who have sex with men (MSM) with human immunodeficiency virus (HIV) in European cohorts. The behaviors mediating this high rate of transmission among MSM are poorly characterized. We performed a prospective cohort study in New York City (NYC) of MSM with HIV who cleared HCV to determine the incidence of and risk factors for HCV reinfection. We assessed the risk behaviors for primary HCV in NYC: receipt of semen in the rectum, and sexualized methamphetamine use, along with route of use. Multivariable analysis was performed with Andersen-Gill extension of the Cox proportional hazards model. From 2000 through 2018, among 304 MSM with HIV who cleared HCV, 42 reinfections occurred over 898 person-years, for an incidence rate of 4.7 per 100 person-years. Assessing 1245 postclearance visits, only receipt of semen into the rectum was associated with reinfection (hazard ratio, 9.7 [95% confidence interval: 3.3-28.3], P < .001); methamphetamine use was not. The high HCV reinfection rate over almost 2 decades demonstrates that sexual transmission of HCV is not inefficient or unusual and that direct-acting antiviral treatment is not sufficient for HCV elimination among MSM in NYC. The contrasts between both the rates of and risk factors for primary and HCV reinfection suggest that HCV prevalence is highly heterogenous among sexual networks and that sexualized methamphetamine use, rather than mediating transmission, is instead a surrogate marker for the highest HCV prevalence networks. As neither condoms nor treatment have been successful strategies for HCV prevention in NYC, novel interventions are needed to stem this sexually transmitted HCV epidemic.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis C virus (HCV) reinfection rates are substantially higher than primary infection rates among men who have sex with men (MSM) with human immunodeficiency virus (HIV) in European cohorts. The behaviors mediating this high rate of transmission among MSM are poorly characterized.
METHODS
METHODS
We performed a prospective cohort study in New York City (NYC) of MSM with HIV who cleared HCV to determine the incidence of and risk factors for HCV reinfection. We assessed the risk behaviors for primary HCV in NYC: receipt of semen in the rectum, and sexualized methamphetamine use, along with route of use. Multivariable analysis was performed with Andersen-Gill extension of the Cox proportional hazards model.
RESULTS
RESULTS
From 2000 through 2018, among 304 MSM with HIV who cleared HCV, 42 reinfections occurred over 898 person-years, for an incidence rate of 4.7 per 100 person-years. Assessing 1245 postclearance visits, only receipt of semen into the rectum was associated with reinfection (hazard ratio, 9.7 [95% confidence interval: 3.3-28.3], P < .001); methamphetamine use was not.
CONCLUSIONS
CONCLUSIONS
The high HCV reinfection rate over almost 2 decades demonstrates that sexual transmission of HCV is not inefficient or unusual and that direct-acting antiviral treatment is not sufficient for HCV elimination among MSM in NYC. The contrasts between both the rates of and risk factors for primary and HCV reinfection suggest that HCV prevalence is highly heterogenous among sexual networks and that sexualized methamphetamine use, rather than mediating transmission, is instead a surrogate marker for the highest HCV prevalence networks. As neither condoms nor treatment have been successful strategies for HCV prevention in NYC, novel interventions are needed to stem this sexually transmitted HCV epidemic.
Identifiants
pubmed: 39023296
pii: 7712798
doi: 10.1093/cid/ciae297
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Gilead Sciences
Investigateurs
Bisher Akil
(B)
Juan Bailey
(J)
Paul Bellman
(P)
Daniel Bowers
(D)
Susanne Burger
(S)
Aviva Cantor
(A)
Rachel Chasan
(R)
Rita Chow
(R)
Robert Cohen
(R)
Patrick Dalton
(P)
John Dellosso
(J)
Eileen Donlon
(E)
Terry Farrow
(T)
Jose Fefer
(J)
Michael Gaisa
(M)
Rodolfo Guadron
(R)
Stuart Haber
(S)
Susan Hefron
(S)
Lawrence Higgins
(L)
Lawrence Hitzeman
(L)
Ricky Hsu
(R)
Victor Inada
(V)
Sneha Jacob
(S)
Livette Johnson
(L)
Barbara Johnston
(B)
Donald Kaminsky
(D)
Oscar Klein
(O)
Jeffrey Kwong
(J)
Jose Lares-Guia
(J)
Eric Leach
(E)
Randy Levine
(R)
Irina Linetskaya
(I)
Larisa Litvinova
(L)
Amisha Malhotra
(A)
William Mandell
(W)
Martin Markowitz
(M)
Gal Mayer
(G)
Eddie Meraz
(E)
Erik Mortensen
(E)
Joseph Olivieri
(J)
Charles Paolino
(C)
Punyadech Photangtham
(P)
George Psevdos
(G)
Steven Rapaport
(S)
Roona Ray
(R)
Gabriela Rodriguez-Caprio
(G)
William Shay
(W)
Nirupama Somasundaram
(N)
Lembitu Sorra
(L)
Richie Tran
(R)
Antonio Urbina
(A)
Francis Wallach
(F)
Wen Wang
(W)
Susan Weiss
(S)
Melissa Wiener
(M)
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Déclaration de conflit d'intérêts
Potential conflicts of interest . D. S. F. reports research funding from Gilead Sciences and Merck, paid to his institution. R. C. reports being on the speakers bureau for Gilead. K. J. B. reports being a paid speaker for Gilead, ViiV, Janssen, and Merck. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.