title: Prevalent and incident hepatitis C virus infection among HIV-infected men who have sex with men engaged in primary care in a Boston community health center.
abstract: BACKGROUND
  Sexually transmitted hepatitis C virus (HCV) infection is an emerging epidemic among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). HCV may be underrecognized in this population, historically thought to be at low risk.
  
  
  METHODS
  We determined the prevalence and incidence of HCV among HIV-infected men at Fenway Health between 1997 and 2009. We describe characteristics associated with HCV.
  
  
  RESULTS
  Of 1171 HIV-infected men, of whom 96% identify as MSM, 1068 (91%) were screened for HCV and 64 (6%) had a positive HCV antibody (Ab) result at initial screening. Among the 995 men whose initial HCV Ab result was negative, 62% received no further HCV Ab testing. Among the 377 men who had ≥1 additional HCV Ab test, 23 (6%) seroconverted over 1408 person-years, for an annualized incidence of 1.63 per 100 person-years (95% confidence interval, .97-2.30). Among the 87 HIV-infected MSM diagnosed with prevalent or incident HCV, 33% reported history of injection drug use, 46% noninjection drug use (NIDU), and 70% sexually transmitted infections (STIs). Sixty-four (74%) of HCV-infected MSM developed chronic HCV; 22 (34%) initiated HCV treatment and 13 (59%) of treated persons achieved a sustained virologic response (SVR).
  
  
  CONCLUSIONS
  Prevalent and incident HCV, primarily acquired through nonparenteral means, was common in this HIV-infected population despite engagement in care. STIs and NIDU were common among HIV/HCV-coinfected MSM. SVR rates were high among those who underwent HCV treatment. All sexually active and/or substance-using HIV-infected MSM should receive routine and repeated HCV screening to allow for early diagnosis and treatment of HCV.
authors: Tufts Medical Center, Boston, MA, USA. shikhagarg75@yahoo.com
authors: Shikha
authors: S
authors: Garg
authors: Lynn E
authors: LE
authors: Taylor
authors: Chris
authors: C
authors: Grasso
authors: Kenneth H
authors: KH
authors: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001900:Boston / Q000453:epidemiology; D003151:Community Health Centers; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
references: Sex Transm Infect. 2010 Feb;86(1):66-70
references: 19720603
references: J Viral Hepat. 2007 Apr;14(4):239-48
references: 17381715
references: Liver Int. 2008 Jul;28(6):781-6
references: 18312289
references: Cochrane Database Syst Rev. 2011 Jun 15;(6):CD003938
references: 21678344
references: AIDS Patient Care STDS. 2011 Oct;25(10):571-7
references: 21859307
references: Clin Infect Dis. 2005 Aug 1;41(3):395-402
references: 16007539
references: AIDS. 2011 May 15;25(8):1083-91
references: 21537114
references: Ann Intern Med. 2002 Dec 17;137(12):961-4
references: 12484711
references: PLoS One. 2011 Mar 08;6(3):e17781
references: 21408083
references: AIDS Behav. 2012 Apr;16(3):676-89
references: 21234666
references: Clin Infect Dis. 2011 Mar 15;52(6):812-8
references: 21282184
references: Clin Infect Dis. 2009 Sep 1;49(5):651-81
references: 19640227
references: PLoS One. 2011;6(12):e29322
references: 22216248
references: Sex Transm Dis. 2012 May;39(5):349-53
references: 22504597
references: Acta Clin Belg. 2011 Jan-Feb;66(1):46-8
references: 21485763
references: BMC Infect Dis. 2011 Feb 03;11:39
references: 21291565
references: AIDS. 2009 Jul 31;23(12):F1-7
references: 19542864
references: J Infect Dis. 2007 Feb 15;195(4):493-501
references: 17230408
references: N Engl J Med. 2011 Jun 23;364(25):2405-16
references: 21696307
references: Clin Infect Dis. 2012 Nov 15;55(10):1408-16
references: 22893583
references: Hepatology. 2007 Dec;46(6):1741-9
references: 18046707
references: Sex Transm Infect. 2008 Apr;84(2):111-5
references: 17932125
references: Arch Intern Med. 2006 Aug 14-28;166(15):1632-41
references: 16908797
references: Euro Surveill. 2005 May;10(5):115-7
references: 16077209
references: Am J Public Health. 2009 Apr;99 Suppl 1:S187-92
references: 19218176
references: MMWR Recomm Rep. 1998 Oct 16;47(RR-19):1-39
references: 9790221
references: AIDS. 2010 Jul 31;24(12):1799-812
references: 20601854
references: AIDS. 2007 May 11;21(8):983-91
references: 17457092
references: Ann Epidemiol. 2005 Jan;15(1):13-20
references: 15571989
references: AIDS. 2006 Nov 28;20(18):2361-9
references: 17117023
references: Clin Infect Dis. 2012 Jul;55 Suppl 1:S33-42
references: 22715212
references: MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110
references: 21160459
references: Euro Surveill. 2010 Sep 30;15(39):19673
references: 20929655
references: MMWR Recomm Rep. 2012 Aug 17;61(RR-4):1-32
references: 22895429
references: MMWR Morb Mortal Wkly Rep. 2011 Jul 22;60(28):945-50
references: 21775948
references: Gastroenterology. 2009 May;136(5):1609-17
references: 19422083
references: Sex Transm Dis. 2007 Aug;34(8):586-91
references: 17334264
references: AIDS. 2011 Feb 20;25(4):399-409
references: 21139491
references: Sex Transm Dis. 2011 Mar;38(3):219-20
references: 20938373
references: J Infect Dis. 2008 Sep 1;198(5):683-6
references: 18627270
references: Hepatology. 2003 Aug;38(2):518-26
references: 12883497
references: Gastroenterology. 2006 Aug;131(2):470-7
references: 16890601