title: Risk Factors for Sexual Transmission of Hepatitis C Virus Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: A Case-Control Study.
abstract: Background.  Since 2000, incidence of sexually acquired hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). To date, few case-control and cohort studies evaluating HCV transmission risk factors were conducted in this population, and most of these studies were initially designed to study HIV-related risk behavior and characteristics. Methods.  From 2009 onwards, HIV-infected MSM with acute HCV infection and controls (HIV-monoinfected MSM) were prospectively included in the MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study at 5 large HIV outpatient clinics in the Netherlands. Written questionnaires were administered, covering sociodemographics, bloodborne risk factors for HCV infection, sexual behavior, and drug use. Clinical data were acquired through linkage with databases from the Dutch HIV Monitoring Foundation. For this study, determinants of HCV acquisition collected at the inclusion visit were analyzed using logistic regression. Results.  Two hundred thirteen HIV-infected MSM (82 MSM with acute HCV infection and 131 MSM without) were included with a median age of 45.7 years (interquartile range [IQR], 41.0-52.2). Receptive unprotected anal intercourse (adjusted odds ratio [aOR], 5.01; 95% confidence interval [CI], 1.63-15.4), sharing sex toys (aOR, 3.62; 95% CI, 1.04-12.5), unprotected fisting (aOR, 2.57; 95% CI, 1.02-6.44), injecting drugs (aOR, 15.62; 95% CI, 1.27-192.6), sharing straws when snorting drugs (aOR, 3.40; 95% CI, 1.39-8.32), lower CD4 cell count (aOR, 1.75 per cubic root; 95% CI, 1.19-2.58), and recent diagnosis of ulcerative sexually transmitted infection (aOR, 4.82; 95% CI, 1.60-14.53) had significant effects on HCV acquisition. Conclusions.  In this study, both sexual behavior and biological factors appear to independently increase the risk of HCV acquisition among HIV-infected MSM.
authors.affiliation: Department of Infectious Diseases , Public Health Service of Amsterdam ; Departments of Medical Microbiology.
authors.forename: Joost W
authors.initials: JW
authors.lastname: Vanhommerig
authors.affiliation: Department of Infectious Diseases , Public Health Service of Amsterdam.
authors.forename: Femke A E
authors.initials: FA
authors.lastname: Lambers
authors.affiliation: Departments of Medical Microbiology.
authors.forename: Janke
authors.initials: J
authors.lastname: Schinkel
authors.affiliation: Department of Infectious Diseases , Public Health Service of Amsterdam ; Clinical Epidemiology, Biostatistics and Bioinformatics , Academic Medical Center , Amsterdam.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.affiliation: Department of Internal Medicine and Infectious Diseases , University Medical Center Utrecht.
authors.forename: Joop E
authors.initials: JE
authors.lastname: Arends
authors.affiliation: Department of Blood-Borne Infections , Sanquin Blood Supply Foundation , Amsterdam.
authors.forename: Thijs J W
authors.initials: TJ
authors.lastname: van de Laar
authors.affiliation: Department of Internal Medicine , Slotervaart Hospital , Amsterdam.
authors.forename: Fanny N
authors.initials: FN
authors.lastname: Lauw
authors.affiliation: Department of Internal Medicine , OLVG Hospital , Amsterdam.
authors.forename: Kees
authors.initials: K
authors.lastname: Brinkman
authors.affiliation: HIV Monitoring Foundation , Amsterdam.
authors.forename: Luuk
authors.initials: L
authors.lastname: Gras
authors.affiliation: Department of Internal Medicine and Infectious Diseases , Erasmus University Medical Center , Rotterdam.
authors.forename: Bart J A
authors.initials: BJ
authors.lastname: Rijnders
authors.affiliation: Department of Internal Medicine , Center of Infectious Diseases and Immunology Amsterdam , Academic Medical Center , The Netherlands.
authors.forename: Jan T M
authors.initials: JT
authors.lastname: van der Meer
authors.affiliation: Department of Infectious Diseases , Public Health Service of Amsterdam ; Department of Internal Medicine , Center of Infectious Diseases and Immunology Amsterdam , Academic Medical Center , The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: J T M
authors.initials: JT
authors.lastname: van der Meer
authors.forename: R
authors.initials: R
authors.lastname: Molenkamp
authors.forename: M
authors.initials: M
authors.lastname: Mutschelknauss
authors.forename: H E
authors.initials: HE
authors.lastname: Nobel
authors.forename: H W
authors.initials: HW
authors.lastname: Reesink
authors.forename: J
authors.initials: J
authors.lastname: Schinkel
authors.forename: M
authors.initials: M
authors.lastname: van der Valk
authors.forename: G E L
authors.initials: GE
authors.lastname: van den Berk
authors.forename: K
authors.initials: K
authors.lastname: Brinkman
authors.forename: D
authors.initials: D
authors.lastname: Kwa
authors.forename: N
authors.initials: N
authors.lastname: van der Meche
authors.forename: A
authors.initials: A
authors.lastname: Toonen
authors.forename: D
authors.initials: D
authors.lastname: Vos
authors.forename: M
authors.initials: M
authors.lastname: van Broekhuizen
authors.forename: F N
authors.initials: FN
authors.lastname: Lauw
authors.forename: J W
authors.initials: JW
authors.lastname: Mulder
authors.forename: J E
authors.initials: JE
authors.lastname: Arends
authors.forename: A
authors.initials: A
authors.lastname: van Kessel
authors.forename: I
authors.initials: I
authors.lastname: de Kroon
authors.forename: A
authors.initials: A
authors.lastname: Boonstra
authors.forename: M E
authors.initials: ME
authors.lastname: van der Ende
authors.forename: S
authors.initials: S
authors.lastname: Hullegie
authors.forename: B J A
authors.initials: BJ
authors.lastname: Rijnders
authors.forename: T J W
authors.initials: TJ
authors.lastname: van de Laar
authors.forename: L
authors.initials: L
authors.lastname: Gras
authors.forename: C
authors.initials: C
authors.lastname: Smit
authors.forename: F A E
authors.initials: FA
authors.lastname: Lambers
authors.forename: M
authors.initials: M
authors.lastname: Prins
authors.forename: J W
authors.initials: JW
authors.lastname: Vanhommerig
authors.forename: W
authors.initials: W
authors.lastname: van der Veldt
keywords: HIV-HCV coinfection; MSM; hepatitis C virus; risk factors; sexual transmission