In the Journals

HCV rates climbing in younger HIV-positive MSM

Hepatitis C infection rates continue to increase in Northern Europe in recent years among younger men who have HIV and have sex with men, with those more recently infected with HIV showing higher rates of HCV infection, according to a recently published article.

“No decline in HCV incidence was observed in recent years, although trends seem to differ by geographical region,” the researchers wrote. “HCV screening among HIV-positive MSM should be continued and routinely and frequently offered. Furthermore, targeted preventive measures should be implemented and/or scaled-up to decrease the risk of HCV acquisition.”

The researchers followed 7,864 men from 16 CASCADE Collaboration cohorts who contracted HIV through sex with men and who had at least one HCV test result (57% white; median age 34 years). Patients were evaluated using three different models. The researchers reported the median follow-up time for the first model (4 years; range, 1.7-7.2 years) and the second model (3.9 years; range, 2-6.3 years).

HCV incidence increased from 0.7 per 1,000 patient-years (95% CI, 0.1-1.5) in 1990 to 18 per 1,000 patient-years (95% CI, 9-37) in 2014, according to the first model, and from 3 per 1,000 patient-years (95% CI, 0.4-18) in 1990 to 21 per 1,000 patient-years (95% CI, 10-24) in 2014, according to the second model.

While the increase in HCV incidence by calendar year in Northern Europe was only significant in the second model (P = .02), the researchers observed a significant increase in Western Europe by calendar year in both the first (P = .001) and second model (P = .005). Incidence rates increased in Western Europe from 14 per 1,000 patient-years (95% CI, 10-20) in 2006 to 23 per 1,000 patient-years (95% CI, 17-31) in 2009. However, Western Europe had a sharp decline afterward to 9 per 1,000 patient-years (95% CI, 3-27) in 2013.

Data from the second model showed a significant association between younger age and HCV infection in MSM with HIV (P = .005).

Regarding the third model, data confirmed an association between higher HIV RNA load and higher HCV incidence (P = .001). HCV incidence was higher during recent HIV infection than during chronic HIV infection (incidence rate ratio = 1.8; 95% CI, 1.1-2.7).

“Further research is needed to assess changes over time in HCV-related risk factors and the proportion of HCV acquisition attributable to sexual practices and drug use among MSM,” the researchers concluded. “Despite the lack of behavioral data, the main focus of our study was to assess temporal trends in HCV incidence, irrespective of the mode of HCV transmission.” – by Talitha Bennett

Disclosure: van Santen reports no relevant financial disclosures. Please see the full study for the other researchers’ relevant financial disclosures.

Hepatitis C infection rates continue to increase in Northern Europe in recent years among younger men who have HIV and have sex with men, with those more recently infected with HIV showing higher rates of HCV infection, according to a recently published article.

“No decline in HCV incidence was observed in recent years, although trends seem to differ by geographical region,” the researchers wrote. “HCV screening among HIV-positive MSM should be continued and routinely and frequently offered. Furthermore, targeted preventive measures should be implemented and/or scaled-up to decrease the risk of HCV acquisition.”

The researchers followed 7,864 men from 16 CASCADE Collaboration cohorts who contracted HIV through sex with men and who had at least one HCV test result (57% white; median age 34 years). Patients were evaluated using three different models. The researchers reported the median follow-up time for the first model (4 years; range, 1.7-7.2 years) and the second model (3.9 years; range, 2-6.3 years).

HCV incidence increased from 0.7 per 1,000 patient-years (95% CI, 0.1-1.5) in 1990 to 18 per 1,000 patient-years (95% CI, 9-37) in 2014, according to the first model, and from 3 per 1,000 patient-years (95% CI, 0.4-18) in 1990 to 21 per 1,000 patient-years (95% CI, 10-24) in 2014, according to the second model.

While the increase in HCV incidence by calendar year in Northern Europe was only significant in the second model (P = .02), the researchers observed a significant increase in Western Europe by calendar year in both the first (P = .001) and second model (P = .005). Incidence rates increased in Western Europe from 14 per 1,000 patient-years (95% CI, 10-20) in 2006 to 23 per 1,000 patient-years (95% CI, 17-31) in 2009. However, Western Europe had a sharp decline afterward to 9 per 1,000 patient-years (95% CI, 3-27) in 2013.

Data from the second model showed a significant association between younger age and HCV infection in MSM with HIV (P = .005).

Regarding the third model, data confirmed an association between higher HIV RNA load and higher HCV incidence (P = .001). HCV incidence was higher during recent HIV infection than during chronic HIV infection (incidence rate ratio = 1.8; 95% CI, 1.1-2.7).

“Further research is needed to assess changes over time in HCV-related risk factors and the proportion of HCV acquisition attributable to sexual practices and drug use among MSM,” the researchers concluded. “Despite the lack of behavioral data, the main focus of our study was to assess temporal trends in HCV incidence, irrespective of the mode of HCV transmission.” – by Talitha Bennett

Disclosure: van Santen reports no relevant financial disclosures. Please see the full study for the other researchers’ relevant financial disclosures.