title: Incidence of hepatitis C virus (HCV) in a multicenter cohort of HIV-positive patients in Spain 2004-2011: increasing rates of HCV diagnosis but not of HCV seroconversions.
abstract: OBJECTIVE
  We aim to describe rates and risk factors of Hepatitis C Virus (HCV) diagnoses, follow-up HCV testing and HCV seroconversion from 2004-2011 in a cohort of HIV-positive persons in Spain.
  
  
  METHODS
  CoRIS is a multicentre, open and prospective cohort recruiting adult HIV-positive patients naïve to antiretroviral therapy. We analysed patients with at least one negative and one follow-up HCV serology. Incidence Rates (IR) were calculated and multivariate Poisson regression was used to estimate adjusted Rates Ratios (aIRR).
  
  
  RESULTS
  Of 2112 subjects, 53 HCV diagnoses were observed, IR = 0.93/100 py (95%CI: 0.7-1.2). IR increased from 0.88 in 2004-05 to 1.36 in 2010-11 (aIRR = 1.55; 95%CI: 0.37-6.55). In men who have sex with men (MSM) from 0.76 to 1.10 (aIRR = 1.45; 95%CI: 0.31-6.82); in heterosexual (HTX) subjects from 1.19 to 1.28 (aIRR = 1.08; 95%CI: 0.11-10.24). HCV seroconversion rates decreased from 1.77 to 0.65 (aIRR = 0.37; 95%CI: 0.12-1.11); in MSM from 1.06 to 0.49 (aIRR = 0.46; 95%CI: 0.09-2.31); in HTX from 2.55 to 0.59 (aIRR = 0.23; 95%CI: 0.06-0.98). HCV infection risk was higher for injecting drug users (IDU) compared to HTX (aIRR = 9.63;95%CI: 2.9-32.2); among MSM, for subjects aged 40-50 compared to 30 or less (IRR = 3.21; 95%CI: 1.7-6.2); and among HTX, for female sex (aIRR = 2.35; 95%CI: 1.03-5.34) and <200 CD4-count (aIRR = 2.39; 95%CI: 0.83-6.89).
  
  
  CONCLUSIONS
  We report increases in HCV diagnoses rates which seem secondary to intensification of HCV follow-up testing but not to rises in HCV infection rates. HCV IR is higher in IDU. In MSM, HCV IR increases with age. Among HTX, HCV IR is higher in women and in subjects with impaired immunological situation.
authors.affiliation: Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Paz
authors.initials: P
authors.lastname: Sobrino-Vegas
authors.affiliation: Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Monge Corella
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Serrano-Villar
authors.affiliation: Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.affiliation: Hospital San Pedro, Logroño, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Blanco
authors.affiliation: Hospital Universitario de La Princesa, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.affiliation: Centro Sanitario Sandoval, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: del Romero
authors.affiliation: Hospital Universitari Parc Taulí, Sabadell, Spain.
authors.forename: Ferrán
authors.initials: F
authors.lastname: Segura
authors.affiliation: Hospital General de Alicante, Alicante, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Santiago Moreno
authors.initials: SM
authors.lastname: Guillén
authors.affiliation: Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: del Amo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D011446:Prospective Studies; D012307:Risk Factors; D019529:Sexuality; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000821:virology; D055815:Young Adult