Incidence and Risk Factors for Incident Hepatitis C Infection Among Men Who Have Sex With Men With HIV-1 Infection in a Large Urban HIV Clinic in Tokyo
ABSTRACT The epidemiology of hepatitis C virus (HCV) infection among HIV-infected men who have sex with men (MSM) who do not inject drugs in Asia remains unknown.
The incidence and risk factors for incident HCV infection among HIV-infected MSM at a large HIV clinic in Tokyo were elucidated. Poisson regression compared the incidence of HCV seroconversion at different observation periods.
Of 753 HIV-1 infected MSM patients negative for HCV antibody (HCVAb) at baseline and available follow-up HCVAb test, 21 patients (2.8%) seroconverted to HCVAb-positive over 2,246 person-years (PY), for an incidence of 9.35/1,000 PY. The incidence increased over time from 0/1,000 PY in 2005 to 2006, 3.0/1,000 PY in 2007 to 2008, 7.7/1,000 PY in 2009 to 2010, and 24.9/1,000 PY in 2011 to 2012 (p=0.012). Of 21 incident cases, only 4 (21%) were injection drug users, and sensitivity analysis that excluded injection drug users yielded similar findings. Multivariate analysis identified illicit drug use to be an independent risk for HCV infection (HR=3.006; 95%CI, 1.092-8.275; p=0.033).
Incident HCV infection is increasing among HIV-1-infected MSM non-injection drug users at resource-rich setting in Asia. Illicit drug use is an independent risk factor for incident HCV infection in this population.
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- "Currently, the epidemic appears to be levelling off in The Netherlands . Outside Europe (the USA and Japan), this seems not to be the case, with recent reported incidence rates being between 0.21 per 100 PYFU and 2.49 per 100 PFYU  . The acute HCV re-infection rate is even higher, with reported rates of 7.8 and 15.2 per 100 PYFU  . "
ABSTRACT: Acute hepatitis C virus (AHCV) infections are frequently seen worldwide in certain risk groups with an annual incidence rate varying between 0.08% and 66%. Although this incidence is substantial, a delayed diagnosis during chronic infection is most often made in the absence of clinical symptoms in the acute phase of the infection. Current used methods to diagnose AHCV are IgG antibody seroconversion and repeated HCV RNA measurements though no definite diagnostic test is currently available. Progress in the field of adaptive and innate immune responses has aided to both advancements in the field of HCV vaccine development and a more basic understanding of viral persistence. The rapid changes in the treatment of chronic HCV will affect therapeutic regimens in AHCV in the coming years leading to shorter treatment courses and pegylated interferon-free modalities. This review gives an overview of the current knowledge and uncertainties together with some future perspectives on acute HCV epidemiology, virology, immunology and treatment. Copyright © 2015. Published by Elsevier Ltd.Clinical Microbiology and Infection 04/2015; DOI:10.1016/j.cmi.2015.03.026 · 5.20 Impact Factor
- JAIDS Journal of Acquired Immune Deficiency Syndromes 05/2014; DOI:10.1097/QAI.0000000000000208 · 4.39 Impact Factor
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ABSTRACT: : Asia is seeing a rise in noncommunicable diseases in their general population and among people living with HIV. Many Asians have low body weight, which can lead to higher plasma concentrations of antiretrovirals and, as a result, their toxicities. Examples are metabolic complications from protease inhibitors, chronic kidney disease from tenofovir, and hepatotoxicity from nevirapine. Asia has not only the highest burden of hepatitis B viral infection than any other continent but also a predominance of genotypes B and C, the latter associated with higher risk for hepatocellular carcinoma. HIV-associated neurocognitive disorders are equally common among Asians as other populations. Diastolic dysfunction and asymptomatic myocardial ischemia are not infrequent. Non-Hodgkin lymphoma is the most common AIDS-related cancer, whereas Kaposi sarcoma is relatively infrequent. Emerging data show high prevalence of human papillomavirus-associated anal dysplasia in men who have sex with men. Resource-limited countries in Asia suffer from lack of resources for national screening programs of noncommunicable diseases, which, in turn, limits the epidemiologic data that exist to guide the use of national health resources.JAIDS Journal of Acquired Immune Deficiency Syndromes 09/2014; 67 Suppl 1:S99-S103. DOI:10.1097/QAI.0000000000000262 · 4.39 Impact Factor