Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review
Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review
复制标题
DOI：
10.1071/sh16141
复制
发表时间：
2017-01-01
期刊：
影响因子：
1.6
通讯作者：
Grulich, Andrew E.
中科院分区：
文献类型：
--
作者：
Jin, Fengyi;Matthews, Gail V.;Grulich, Andrew E.
对同性恋和双性恋男性（GBM）中丙型肝炎病毒（HCV）性传播的证据进行了系统评价。纳入了2000年至2015年在工业化国家进行并以英语发表的研究，其中包含GBM中HCV的数据。HCV感染的患病率和发生率的合并估计值通过研究设置和参与者的HIV状态使用随机效应模型分层。对病例系列报告进行了总结。在38项横断面研究中，合并的HCV患病率在HIV阳性男性中显著较高（8.3%，95% CI：6.7-9.9）比艾滋病毒阴性男性（1.5%，95%CI 0.8-2.1），报告注射吸毒者（34.8%，95%CI 26.9-42.7）高于未报告注射吸毒者（3.5%，95%CI 2.4-4.5）。在16项纵向研究中，以临床为基础的研究中，合并的HCV发病率明显较高，（7.0/1000人-年，95% CI 4.6-9.5）（1.4/1000人-年，95% CI 0.7-2.1）研究，以及HIV阳性男性（6.4/1000人-年，95% CI 4.6-8.1）比HIV阴性男性（0.4/1000人-年，95% CI 0-0.9）。自2000年代初以来，15份病例系列报告越来越多地指出丙型肝炎病毒性传播在主要是艾滋病毒阳性男性中的重要性。注射吸毒仍是GBM中HCV的主要传播途径。接受性无安全套性交和并发溃疡性性传播感染可能是促进HIV阳性男性中HCV性传播的驱动因素。在HIV阴性的GBM中，HCV的发病率仍然很低。
A systematic review was performed on the evidence of sexual transmission of hepatitis C virus (HCV) in gay and bisexual men (GBM). Studies conducted in industrialised countries and published in English from 2000 to 2015 with data on HCV in GBM were included. Pooled estimates of prevalence and incidence of HCV infection were stratified by study settings and participants' HIV status using random effect models. Case-series reports were summarised descriptively. Of the 38 cross-sectional studies, the pooled HCV prevalence was substantially higher in HIV-positive men (8.3%, 95% CI: 6.7-9.9) than in HIV-negative men (1.5%, 95% CI 0.8-2.1), and higher in those who reported injecting drug use (34.8%, 95% CI 26.9-42.7) than in those who did not (3.5%, 95% CI 2.4-4.5). Of the 16 longitudinal studies, the pooled HCV incidence was markedly higher in clinic-based (7.0 per 1000 person-years, 95% CI 4.6-9.5) than in community-based (1.4 per 1000 person-years, 95% CI 0.7-2.1) studies, and in HIV-positive men (6.4 per 1000 person-years, 95% CI 4.6-8.1) than in HIV-negative men (0.4 per 1000 person-years, 95% CI 0-0.9). Since the early 2000s, 15 case-series reports increasingly pointed to the importance of sexual transmission of HCV in mainly HIV-positive men. Injecting drug use remained the major transmission route of HCV in GBM. Receptive condomless intercourse and concurrent ulcerative sexually transmissible infections are likely drivers that facilitated HCV sexual transmission in HIV-positive men. HCV incidence remains very low in HIV-negative GBM.