High Number of Potential Transmitters Revealed in a Population-based Systematic Hepatitis C Virus RNA Screening Among Human Immunodeficiency Virus-infected Men Who Have Sex With Men
Dominique L Braun, Benjamin Hampel, Eileen Martin, Roger Kouyos, Katharina Kusejko, Christina Grube, Markus Flepp, Marcel Stöckle, Anna Conen, Charles Béguelin, Patrick Schmid, Julie Delaloye, Mathieu Rougemont, Enos Bernasconi, Andri Rauch, Huldrych F Günthard, Jürg Böni, Jan S Fehr, Swiss HIV Cohort Study, A Anagnostopoulos, M Battegay, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fellay, H Furrer, C A Fux, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, C Kahlert, L Kaiser, O Keiser, T Klimkait, H Kovari, B Ledergerber, G Martinetti, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, D Nicca, P Paioni, G Pantaleo, M Perreau, C Rudin, A U Scherrer, R Speck, P Tarr, A Trkola, P Vernazza, G Wandeler, R Weber, S Yerly, Dominique L Braun, Benjamin Hampel, Eileen Martin, Roger Kouyos, Katharina Kusejko, Christina Grube, Markus Flepp, Marcel Stöckle, Anna Conen, Charles Béguelin, Patrick Schmid, Julie Delaloye, Mathieu Rougemont, Enos Bernasconi, Andri Rauch, Huldrych F Günthard, Jürg Böni, Jan S Fehr, Swiss HIV Cohort Study, A Anagnostopoulos, M Battegay, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fellay, H Furrer, C A Fux, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, C Kahlert, L Kaiser, O Keiser, T Klimkait, H Kovari, B Ledergerber, G Martinetti, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, D Nicca, P Paioni, G Pantaleo, M Perreau, C Rudin, A U Scherrer, R Speck, P Tarr, A Trkola, P Vernazza, G Wandeler, R Weber, S Yerly
Abstract
Background: The proportion of undiagnosed hepatitis C virus (HCV) infections in high-risk populations, such as human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) is unclear. Identification of potential HCV transmitters is important to reach World Health Organization HCV elimination targets.
Methods: Between October 2015 and May 2016, we performed a systematic HCV RNA-based screening among HIV-infected MSM participating in the Swiss HIV Cohort Study (SHCS). HCV antibodies were measured from all HCV RNA-positive samples.
Results: Of 4257 MSM recorded in the SHCS database, we screened 3722 (87%) by HCV polymerase chain reaction, and 177 (4.8%) harbored a replicating HCV infection. We identified 24 individuals (14%) with incident HCV infection; one-third of them had a negative HCV antibody result at the time of HCV RNA positivity. In a multivariable model, elevated liver enzyme values (odds ratio, 14.52; 95% confidence interval, 9.92-21.26), unprotected sex with occasional partners (2.01; 1.36-2.98), intravenous drug use (7.13; 4.36-11.64), noninjectable drug use (1.94; 1.3-2.88), and previous syphilis diagnosis (2.56; 1.74-3.76) were associated with HCV RNA positivity.
Conclusions: A systematic HCV RNA-based screening among HIV-infected MSM revealed a high number of potential transmitters. A substantial subpopulation of MSM had incident infection, one-third of whom had a negative HCV antibody test result at the time of the HCV RNA positivity. These data reveal that one-time RNA testing of a high-risk population for HCV RNA might identify more infected persons than routine testing for HCV antibodies and liver enzymes.
Clinical trials registration: NCT02785666.
Source: PubMed