Incident hepatitis C virus infection among US HIV-infected men enrolled in clinical trials.

TitleIncident hepatitis C virus infection among US HIV-infected men enrolled in clinical trials.
Publication TypeJournal Article
Year of Publication2011
AuthorsTaylor LE, Holubar M, Wu K, Bosch RJ, Wyles DL, Davis JA, Mayer KH, Sherman KE, Tashima KT
JournalClin Infect Dis
Volume52
Issue6
Pagination812-8
Date Published2011 Mar 15
ISSN1537-6591
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, CD4 Lymphocyte Count, Cohort Studies, Hepatitis C, HIV Infections, Humans, Incidence, Male, Middle Aged, Randomized Controlled Trials as Topic, Substance-Related Disorders, United States, Viral Load, Young Adult
Abstract

BACKGROUND: Outbreaks of sexually transmitted hepatitis C virus (HCV) infection have been reported among human immunodeficiency virus (HIV)-infected men who have sex with men in Europe, Australia, and New York. Whether this is occurring across the United States is unknown.

METHODS: We determined incidence of HCV infection during 1996-2008 among male participants of the AIDS Clinical Trial Group Longitudinal Linked Randomized Trials cohort, a long-term study of HIV-infected persons randomized into selected US-based clinical trials. We evaluated associations with self-reported injection drug use (IDU), time-varying CD4(+) cell count, and HIV RNA level with use of multivariate Poisson regression. No sexual or non-IDU risk factor data was available.

RESULTS: A total of 1830 men had an initial negative HCV antibody test result and at least 1 subsequent HCV antibody test result, contributing >7000 person-years. At the time of the initial negative HCV antibody test result, 94% of men were receiving highly active antiretroviral therapy (HAART) and 6% reported current or prior IDU. Thirty-six seroconverted, with overall incidence of .51 cases per 100 person-years (95% confidence interval, .36-.70). Mean age at seroconversion was 46 years. Seroconversion was associated with IDU (25% of seroconverters reported IDU history vs 5% of nonseroconverters; P < .001), whereas 75% (n = 27) of seroconverters reported no IDU (incidence, 2.67 cases per 100 person-years among IDUs, .40 cases per 100 person-years among non-IDUs). Seroconversion was associated with HIV RNA level >400 copies/mL (44% at time of antibody positivity vs 21% at time of last negative antibody test result; P = .02) but not with CD4(+) cell count.

CONCLUSIONS: Incident HCV infection occurs in HIV-infected men involved in US HIV therapeutic trials, primarily through nonparenteral means, despite engagement in care and HAART. HCV antibody development was not related to immune status but was associated with inadequate HIV suppression. At-risk HIV-infected persons should have access to HCV surveillance.

DOI10.1093/cid/ciq201
Alternate JournalClin. Infect. Dis.
PubMed ID21282184
PubMed Central IDPMC3106260
Grant List5U 01 AI069474 / AI / NIAID NIH HHS / United States
AI 38855 / AI / NIAID NIH HHS / United States
AI 38858, / AI / NIAID NIH HHS / United States
AI 68634 / AI / NIAID NIH HHS / United States
AI 68636 / AI / NIAID NIH HHS / United States
K23 DA020383 / DA / NIDA NIH HHS / United States
P30 AI42853 / AI / NIAID NIH HHS / United States
P30 DA013868 / DA / NIDA NIH HHS / United States
U01 AI069472 / AI / NIAID NIH HHS / United States