title: Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, Health Service Amsterdam, 1000 CE Amsterdam, The Netherlands. tvdlaar@ggd.amsterdam.nl
authors.forename: Thijs J W
authors.initials: TJ
authors.lastname: van de Laar
authors.forename: Akke K
authors.initials: AK
authors.lastname: van der Bij
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Bruisten
authors.forename: Kees
authors.initials: K
authors.lastname: Brinkman
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Ruys
authors.forename: Jan T M
authors.initials: JT
authors.lastname: van der Meer
authors.forename: Henry J C
authors.initials: HJ
authors.lastname: de Vries
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Mulder
authors.forename: Michiel
authors.initials: M
authors.lastname: van Agtmael
authors.forename: Suzanne
authors.initials: S
authors.lastname: Jurriaans
authors.forename: Katja C
authors.initials: KC
authors.lastname: Wolthers
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
mesh_terms: 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*
chemical_list: D018937:Hepatitis C Antibodies