title: Low prevalence of hepatitis C co-infection in recently HIV-infected minority men who have sex with men in Los Angeles: a cross-sectional study.
abstract: BACKGROUND
  Geographic and sociodemographic characterization of hepatitis C virus (HCV) transmission amongst men who have sex with men (MSM) has been limited. Our aim was to characterize HCV prevalence, risk factors for HCV co-infection, and patterns of HIV and HCV co-transmission and transmitted drug resistance mutations (DRMs) in newly HIV-diagnosed Los Angeles MSM.
  
  
  METHODS
  Viral RNA was extracted from stored plasma samples from a Los Angeles cohort of newly diagnosed HIV-infected MSM with well-characterized substance use and sexual behavioral characteristics via computer-assisted self-interviewing surveys. Samples were screened for HCV by qPCR. HCV E1, E2, core, NS3 protease and NS5B polymerase and HIV-1 protease and reverse transcriptase regions were amplified and sequenced. Phylogenetic analysis was used to determine relatedness of HCV and HIV-1 isolates within the cohort and viral sequences were examined for DRMs.
  
  
  RESULTS
  Of 185 newly HIV-diagnosed MSM, the majority (65%) were of minority race/ethnicity and recently infected (57.8%), with median age of 28.3 years. A minority (6.6%) reported injection drug use (IDU), whereas 96 (52.8%) reported recent substance use, primarily cannabis or stimulant use. High risk sexual behaviors included 132 (74.6%) with unprotected receptive anal intercourse, 60 (33.3%) with group sex, and 10 (5.7%) with fisting. Forty-five (24.3%) had acute gonorrhea or chlamydia infection. Only 3 (1.6%) subjects had detectable HCV RNA. Amongst these subjects, HIV and HCV isolates were unrelated by phylogenetic analysis and none possessed clinically relevant NS3 or NS5B HCV DRMs.
  
  
  CONCLUSIONS
  Prevalence of HCV co-infection was low and there was no evidence of HIV-HCV co-transmission in this cohort of relatively young, predominantly minority, newly HIV-diagnosed MSM, most with early HIV infection, with high rates of high risk sexual behaviors, STI, and non-IDU. The low HCV prevalence in a group with high-risk behaviors for non-IDU HCV acquisition suggests an opportune time for targeted HCV prevention measures.
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd, Suite 100, Los Angeles, CA, 90025, USA. kchew@mednet.ucla.edu.
authors.forename: Kara W
authors.initials: KW
authors.lastname: Chew
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles, CA, 90095, USA. Martha.blum@chomp.org.|Present Address: Community Hospital of the Monterey Peninsula, Infectious Diseases Division, 23625 Holman Highway, Monterey, CA, 93942, USA. Martha.blum@chomp.org.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Blum
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, 71-235E CHS, Los Angeles, CA, 90095, USA. javan@ucla.edu.
authors.forename: Marjan
authors.initials: M
authors.lastname: Javanbakht
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles, CA, 90095, USA. lclare2014@gmail.com.
authors.forename: Laurel E
authors.initials: LE
authors.lastname: Clare
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles, CA, 90095, USA. loreleibornfleth@gmail.com.
authors.forename: Lorelei D
authors.initials: LD
authors.lastname: Bornfleth
authors.affiliation: Los Angeles LGBT Center, 1625 N. Schrader Blvd, Los Angeles, CA, 90028, USA. bbolan@lalgbtcenter.org.
authors.forename: Robert
authors.initials: R
authors.lastname: Bolan
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles, CA, 90095, USA. debikab@mednet.ucla.edu.
authors.forename: Debika
authors.initials: D
authors.lastname: Bhattacharya
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, 71-235E CHS, Los Angeles, CA, 90095, USA. pgorbach@ucla.edu.|Department of Medicine, David Geffen School of Medicine at UCLA, 41-295 CHS, Los Angeles, CA, 90095, USA. pgorbach@ucla.edu.
authors.forename: Pamina M
authors.initials: PM
authors.lastname: Gorbach
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology* / Q000635:transmission; D003430:Cross-Sectional Studies; D005006:Ethnicity; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000201:enzymology / Q000235:genetics; D016174:Hepacivirus / Q000201:enzymology / Q000235:genetics; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D012367:RNA, Viral