Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission.
We retrospectively screened 1836 men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (1984-2003) for hepatitis C virus (HCV) antibodies. HCV incidence was 0.18/100 person-years (PY) in human immunodeficiency virus (HIV)-positive MSM (8/4408 PY [95% confidence interval {CI}, 0.08-0.36]) but was 0/100 PY in MSM without HIV (0/7807 PY [95% CI, 0.00-0.05]). After 2000, HCV incidence among HIV-positive men increased 10-fold to 0.87/100 PY (5/572 PY [95% CI, 0.28-2.03]). Additional hospital cases (n=34) showed that MSM in Amsterdam who acquired HCV infection after 2000 reported high rates of ulcerative sexually transmitted infections (59%) and rough sexual techniques (56%), denied injection drug use, and were infected mainly with the difficult-to-treat HCV genotypes 1 (56%) and 4 (36%). Phylogenetic analysis showed 3 monophyletic clusters of MSM-specific HCV strains. The emergence of an MSM-specific transmission network suggests that HIV-positive MSM with high-risk sexual behaviors are at risk for sexually acquired HCV. Targeted prevention and routine HCV screening among HIV-positive MSM is needed to deter the spread of HCV.
van de Laar
Thijs J W
TJ
Department of Infectious Diseases, Health Service Amsterdam, 1000 CE Amsterdam, The Netherlands. tvdlaar@ggd.amsterdam.nl
van der Bij
Akke K
AK
Prins
Maria
M
Bruisten
Sylvia M
SM
Brinkman
Kees
K
Ruys
Thomas A
TA
van der Meer
Jan T M
JT
de Vries
Henry J C
HJ
Mulder
Jan-Willem
JW
van Agtmael
Michiel
M
Jurriaans
Suzanne
S
Wolthers
Katja C
KC
Coutinho
Roel A
RA
D000328:Adult; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010802:Phylogeny; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D015229:Sexually Transmitted Diseases, Viral / Q000635:transmission*
D018937:Hepatitis C Antibodies