Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have sex with men: The swiss HIV cohort study
Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have sex with men: The swiss HIV cohort study
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DOI：
10.1086/431486
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发表时间：
2005-08-01
影响因子：
11.8
通讯作者：
Furrer, H
中科院分区：
文献类型：
--
作者：
Rauch, A;Rickenbach, M;Furrer, H
背景。关于人类免疫缺陷病毒（HIV）感染者中丙型肝炎病毒（HCV）感染发生率的数据很少。丙型肝炎病毒是否通过无保护的性交传播以及传播的频率是有争议的。我们评估了1988年至2004年瑞士HIV队列研究中的HCV血清患病率和HCV感染发生率。我们调查了HCV血清转化与HIV获取方式、性行为、注射药物使用（IDU）和避孕套使用的持续性之间的关系。在2000年至2004年期间，前瞻性地收集了安全套使用或不安全性行为的数据。在7899名符合条件的参与者中，HCV感染的总体血清阳性率为33%，在报告IDU的人群中为90%。在16305人-年的总随访时间内，我们观察到3327名参与者中有104例HCV血清转化，对应于每100人-年0.64例的发病率。有IDU病史的参与者的发病率为每100人年7.4例，而没有此类病史的患者的发病率为每100人年0.23例（）。在报告不安全性行为的无IDU史的男男性行为者（MSM）中，发生率为每100人年0.7例，而未报告不安全性行为者为每100人年0.2例（），发生率比为3.5（95%可信区间为1.2 - 10.0）。在年轻的男男性行为者中，获得HCV感染的风险升高。瑞士HIV队列研究中的HCV感染发生率主要与IDU相关。在HIV感染的男男性行为者中，HCV感染与不安全性行为有关。
Background. Data on the incidence of hepatitis C virus ( HCV) infection among human immunodeficiency virus ( HIV) - infected persons are sparse. It is controversial whether and how frequently HCV is transmitted by unprotected sexual intercourse.Methods. We assessed the HCV seroprevalence and incidence of HCV infection in the Swiss HIV Cohort Study between 1988 and 2004. We investigated the association of HCV seroconversion with mode of HIV acquisition, sex, injection drug use ( IDU), and constancy of condom use. Data on condom use or unsafe sexual behavior were prospectively collected between 2000 and 2004.Results. The overall seroprevalence of HCV infection was 33% among a total of 7899 eligible participants and 90% among persons reporting IDU. We observed 104 HCV seroconversions among 3327 participants during a total follow- up time of 16,305 person- years, corresponding to an incidence of 0.64 cases per 100 person- years. The incidence among participants with a history of IDU was 7.4 cases per 100 person- years, compared with 0.23 cases per 100 person- years in patients without such a history (). In men who had sex with men ( MSM) P < 001 without a history of IDU who reported unsafe sex, the incidence was 0.7 cases per 100 person- years, compared with 0.2 cases per 100 person- years in those not reporting unsafe sex (), corresponding to an incidence rate ratio of 3.5 ( 95% confidence interval, 1.2 - 10.0). The hazard of acquiring HCV infection was elevated among younger participants who were MSM.Conclusions. HCV infection incidence in the Swiss HIV Cohort Study was mainly associated with IDU. In HIV- infected MSM, HCV infection was associated with unsafe sex.