Advertisement

Infection

, Volume 41, Issue 5, pp 987–990 | Cite as

Changing characteristics and risk factors of patients with and without incident HCV infection among HIV-infected individuals

  • E. Orsetti
  • S. Staffolani
  • R. Gesuita
  • G. De Iaco
  • E. Marchionni
  • L. Brescini
  • P. Castelli
  • F. Barchiesi
Brief Report

Abstract

Background

Chronic hepatitis C virus (HCV) infection has become a leading cause of non-acquired immunodeficiency syndrome (AIDS)-related morbidity and mortality for human immunodeficiency virus (HIV)-infected persons in the highly active antiretroviral therapy (HAART) era. Despite injection drug use (IDU) remaining the main route of HCV infection, recent reports indicate outbreaks of acute HCV infection among HIV-infected men who have sex with men (MSM) and sexually transmitted infections in the absence of IDU.

Methods

We conducted a retrospective observational study of behavioural and demographic factors of patients with and without incident HCV infection among HIV-infected individuals followed at the AIDS Clinic of the Infectious Disease Department of the University of Ancona from 1989 to 2011.

Results

Overall, 440 patients were considered; a total of 145 patients had initial positive HCV antibody test results (HCV+); a total of 295 patients had initial negative HCV antibody test results (HCV−). In the latter population, 14 seroconverted to HCV antibody (neoHCV), with an overall incidence of 0.59 per 100 person-years. While IDU was the principal risk factor of HCV+, the main route of transmission of incident HCV infection was sexual transmission. The HCV− group was significantly older than the other two groups and showed a significantly lower CD4 count at HIV diagnosis than neoHCV. Being Italian and having a low level of education were significantly more represented in HCV+. Younger age at HIV infection, IDU and additional risk factors other than sexual transmission significantly affected the probability of being HCV+. The cumulative probability of developing HCV infection in the HCV− group was calculated to be 6 % at 15 years.

Conclusions

The epidemiology of the newly acquired HCV in HIV+ persons is changing. Therefore, a frequent and constant counselling about HCV infection is desirable and a periodical screening test is mandatory.

Keywords

Human Immunodeficiency Virus Human Immunodeficiency Virus Diagnosis AIDS Clinic Infectious Disease Department Initial Human Immunodeficiency Virus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

References

  1. 1.
    Thomas DL. HIV/HCV coinfection: comorbidity and clinical implications. Adv Stud Med. 2005;5:S352–5.Google Scholar
  2. 2.
    Matthews GV, Pham ST, Hellard M, Grebely J, Zhang L, Oon A, et al. Patterns and characteristics of hepatitis C transmission clusters among HIV-positive and HIV-negative individuals in the Australian trial in acute hepatitis C. Clin Infect Dis. 2011;52(6):803–11.Google Scholar
  3. 3.
    Berenguer J, Alvarez-Pellicer J, Martín PM, López-Aldeguer J, Von-Wichmann MA, Quereda C, et al. Sustained virological response to interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus. Hepatology. 2009;50:407–13.PubMedCrossRefGoogle Scholar
  4. 4.
    Bruno S, Stroffolini T, Colombo M, Bollani S, Benvegnù L, Mazzella G, et al. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study. Hepatology. 2007;45:579–87.PubMedCrossRefGoogle Scholar
  5. 5.
    Singal AG, Volk ML, Jensen D, Di Bisceglie AM, Schoenfeld PS. A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with hepatitis C virus. Clin Gastroenterol Hepatol. 2010;8:280–8, 288.e1.PubMedCrossRefGoogle Scholar
  6. 6.
    Matthews GV, Hellard M, Haber P, Yeung B, Marks P, Baker D, et al. Characteristics and treatment outcomes among HIV-infected individuals in the Australian Trial in Acute Hepatitis C. Clin Infect Dis. 2009;48:650–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Marincovich B, Castilla J, del Romero J, García S, Hernando V, Raposo M, et al. Absence of hepatitis C virus transmission in a prospective cohort of heterosexual serodiscordant couples. Sex Transm Infect. 2003;79:160–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Terrault NA. Sexual activity as a risk factor for hepatitis C. Hepatology. 2002;36:S99–105.PubMedCrossRefGoogle Scholar
  9. 9.
    Alary M, Joly JR, Vincelette J, Lavoie R, Turmel B, Remis RS. Lack of evidence of sexual transmission of hepatitis C virus in a prospective cohort study of men who have sex with men. Am J Public Health. 2005;95:502–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Rauch A, Rickenbach M, Weber R, Hirschel B, Tarr PE, Bucher HC, et al. Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have sex with men: the Swiss HIV Cohort Study. Clin Infect Dis. 2005;41:395–402.PubMedCrossRefGoogle Scholar
  11. 11.
    Browne R, Asboe D, Gilleece Y, Atkins M, Mandalia S, Gazzard B, et al. Increased numbers of acute hepatitis C infections in HIV positive homosexual men; is sexual transmission feeding the increase? Sex Transm Infect. 2004;80:326–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Götz HM, van Doornum G, Niesters HG, den Hollander JG, Thio HB, de Zwart O. A cluster of acute hepatitis C virus infection among men who have sex with men—results from contact tracing and public health implications. AIDS. 2005;19:969–74.PubMedCrossRefGoogle Scholar
  13. 13.
    Gambotti L, Batisse D, Colin-de-Verdiere N, Delaroque-Astagneau E, Desenclos JC, Dominguez S, et al. Acute hepatitis C infection in HIV positive men who have sex with men in Paris, France, 2001–2004. Euro Surveill. 2005;10:115–7.PubMedGoogle Scholar
  14. 14.
    van de Laar TJ, Van der Bij AK, Prins M, Bruisten SM, Brinkman K, Ruys TA, et al. Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission. J Infect Dis. 2007;196:230–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Danta M, Brown D, Bhagani S, Pybus OG, Sabin CA, Nelson M, et al. Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours. AIDS. 2007;21:983–91.PubMedCrossRefGoogle Scholar
  16. 16.
    Serpaggi J, Chaix ML, Batisse D, Dupont C, Vallet-Pichard A, Fontaine H, et al. Sexually transmitted acute infection with a clustered genotype 4 hepatitis C virus in HIV-1-infected men and inefficacy of early antiviral therapy. AIDS. 2006;20:233–40.PubMedCrossRefGoogle Scholar
  17. 17.
    Fierer DS, Uriel AJ, Carriero DC, Klepper A, Dieterich DT, Mullen MP, et al. Liver fibrosis during an outbreak of acute hepatitis C virus infection in HIV-infected men: a prospective cohort study. J Infect Dis. 2008;198:683–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Luetkemeyer A, Hare CB, Stansell J, Tien PC, Charlesbois E, Lum P, et al. Clinical presentation and course of acute hepatitis C infection in HIV-infected patients. J Acquir Immune Defic Syndr. 2006;41:31–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Holubar M, Taylor L, Wu K, Bosch R, Mayer K, Tashima K. Hepatitis C virus (HCV) antibody seroconversion in a US. HIV-infected male clinical trials population. In: 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), Boston, MA, USA, October/November 2009. Abstract LB14Google Scholar
  20. 20.
    Matthews GV, Hellard M, Kaldor J, Lloyd A, Dore GJ. Further evidence of HCV sexual transmission among HIV-positive men who have sex with men: response to Danta et al. AIDS. 2007;21:2112–3.PubMedCrossRefGoogle Scholar
  21. 21.
    Taylor LE, Holubar M, Wu K, Bosch RJ, Wyles DL, Davis JA, et al. Incident hepatitis C virus infection among US HIV-infected men enrolled in clinical trials. Clin Infect Dis. 2011;52:812–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Turner JM, Rider AT, Imrie J, Copas AJ, Edwards SG, Dodds JP, et al. Behavioural predictors of subsequent hepatitis C diagnosis in a UK clinic sample of HIV positive men who have sex with men. Sex Transm Infect. 2006;82:298–300.PubMedCrossRefGoogle Scholar
  23. 23.
    Browne R, Asboe D, Gilleece Y, Atkins M, Mandalia S, Gazzard B, et al. Increased numbers of acute hepatitis C infections in HIV positive homosexual men; is sexual transmission feeding the increase? Sex Transm Infect. 2004;80:326–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Thomson EC, Nastouli E, Main J, Karayiannis P, Eliahoo J, Muir D, McClure MO. Delayed anti-HCV antibody response in HIV-positive men acutely infected with HCV. AIDS. 2009;23:89–93.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • E. Orsetti
    • 1
  • S. Staffolani
    • 1
  • R. Gesuita
    • 2
  • G. De Iaco
    • 1
  • E. Marchionni
    • 1
  • L. Brescini
    • 1
  • P. Castelli
    • 1
  • F. Barchiesi
    • 1
  1. 1.Clinica Malattie InfettiveUniversità Politecnica delle MarcheAnconaItaly
  2. 2.Centro di Epidemiologia e BiostatisticaUniversità Politecnica delle MarcheAnconaItaly

Personalised recommendations