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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 26 (2015), Issue 1, Pages 17-22
Original Article

Hepatitis C Virus Seroconversion among Hiv-Positive Men Who Have Sex with Men with No History of Injection Drug Use: Results from a Clinical Hiv Cohort

Ann N Burchell,1,2 Sandra L Gardner,1,2 Tony Mazzulli,3,4,5 Michael Manno,1 Janet Raboud,2,6 Vanessa G Allen,3 Ahmed M Bayoumi,7,8,9 Rupert Kaul,9 Frank McGee,10 Peggy Millson,2 Robert S Remis,2,3 Wendy Wobeser,11,12 Curtis Cooper,13,14 and Sean B Rourke1,7,15

1Ontario HIV Treatment Network, Canada
2Dalla Lana School of Public Health, University of Toronto, Canada
3Public Health Laboratories, Public Health Ontario, Canada
4Department of Microbiology, Mount Sinai Hospital, Canada
5Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada
6Toronto General Research Institute, University Health Network, Canada
7Centre for Research on Inner City Health, The Keenan Research Centre in the Li KaShing Knowledge Institute, St Michael’s Hospital, Canada
8Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
9Department of Medicine, University of Toronto, Canada
10AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Canada
11Hotel Dieu Hospital, Canada
12Queen’s University, Kingston, Canada
13Ottawa Hospital, Canada
14University of Ottawa, Ottawa, Canada
15Department of Psychiatry, University of Toronto, Canada

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Internationally, there is a growing recognition that hepatitis C virus (HCV) may be sexually transmitted among HIV-positive men who have sex with men (MSM).

OBJECTIVE: To report the first Canadian estimate of HCV seroincidence in 2000 to 2010 and its risk factors among HIV-positive MSM with no known history of injection drug use.

METHODS: Data from the Ontario HIV Treatment Network Cohort Study, an ongoing cohort of individuals in HIV care in Ontario, were analyzed. Data were obtained from medical charts, interviews and record linkage with the provincial public health laboratories. The analysis was restricted to 1534 MSM who did not report injection drug use and had undergone ≥2 HCV antibody tests, of which the first was negative (median 6.1 person-years [PY] of follow-up; sum 9987 PY).

RESULTS: In 2000 to 2010, 51 HCV seroconversions were observed, an overall incidence of 5.1 per 1000 PY (95% CI 3.9 to 6.7). Annual incidence varied from 1.6 to 8.9 per 1000 PY, with no statistical evidence of a temporal trend. Risk for seroconversion was elevated among men who had ever had syphilis (adjusted HR 2.5 [95% CI 1.1 to 5.5) and men who had acute syphilis infection in the previous 18 months (adjusted HR 2.8 [95% CI 1.0 to 7.9]). Risk was lower for men who had initiated antiretroviral treatment (adjusted HR 0.49 [95% CI 0.25 to 0.95]). There were no statistically significant effects of age, ethnicity, region, CD4 cell count or HIV viral load.

CONCLUSIONS: These findings suggest that periodic HCV rescreening may be appropriate in Ontario among HIV-positive MSM. Future research should seek evidence whether syphilis is simply a marker for high-risk sexual behaviour or networks, or whether it potentiates sexual HCV transmission among individuals with HIV.