title: Recent hepatitis C virus infections in HIV-infected patients in Taiwan: incidence and risk factors.
abstract: Outbreaks of sexually transmitted hepatitis C virus (HCV) infections have been recently reported in HIV-infected men who have sex with men (MSM) in Europe, Australia, and North America. Little is known concerning whether this also occurs in other Asia-Pacific countries. Between 1994 and 2010, a prospective observational cohort study was performed to assess the incidence of recent HCV seroconversion in 892 HIV-infected patients (731 MSM and 161 heterosexuals) who were not injecting drug users. A nested case-control study was conducted to identify associated factors with recent HCV seroconversion, and phylogenetic analysis was performed using NS5B sequences amplified from seroconverters. During a total followup duration of 4,270 person-years (PY), 30 patients (3.36%) had HCV seroconversion, with an overall incidence rate of 7.03 per 1,000 PY. The rate increased from 0 in 1994 to 2000 and 2.29 in 2001 to 2005 to 10.13 per 1,000 PY in 2006 to 2010 (P < 0.05). After adjustment for age and HIV transmission route, recent syphilis remained an independent factor associated with HCV seroconversion (odds ratio, 7.731; 95% confidence interval, 3.131 to 19.086; P < 0.01). In a nested case-control study, seroconverters had higher aminotranferase levels and were more likely to have CD4 ≥ 200 cells/μl and recent syphilis than nonseroconverters (P < 0.05). Among the 21 patients with HCV viremia, phylogenetic analysis revealed 7 HCV transmission clusters or pairs (4 within genotype 1b, 2 within genotype 2a, and 1 within genotype 3a). The incidence of HCV seroconversion that is associated with recent syphilis is increasing among HIV-infected patients in Taiwan.
authors.affiliation: Departments of Internal Medicinea and Laboratory Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. hcc0401@ntu.edu.tw
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.forename: Sui-Yuan
authors.initials: SY
authors.lastname: Chang
authors.forename: Zong-Yu
authors.initials: ZY
authors.lastname: Yang
authors.forename: Ching-Lan
authors.initials: CL
authors.lastname: Lu
authors.forename: Hsiu
authors.initials: H
authors.lastname: Wu
authors.forename: Chang-Ching
authors.initials: CC
authors.lastname: Yeh
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Liu
authors.forename: Chia-Yin
authors.initials: CY
authors.lastname: Hsieh
authors.forename: Chien-Ching
authors.initials: CC
authors.lastname: Hung
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016000:Cluster Analysis; D015331:Cohort Studies; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D011446:Prospective Studies; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013624:Taiwan / Q000453:epidemiology; D017361:Viral Nonstructural Proteins / Q000235:genetics; D012324:RNA-Dependent RNA Polymerase
chemical_list: D017361:Viral Nonstructural Proteins; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase