Concurrent transmission of HCV and bacterial STI in HIV-infected MSM
Refereed conference paper presented and published in conference proceedings

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AbstractBackground: Worldwide, sexual transmission of HCV has become widely reported in MSM, especially among those HIV infected. Its association with other bacterial sexually transmitted infections (STI) has not been well characterised.

Methods: Clinical data and blood samples of HIV patients diagnosed with acute HCV infection were collected from a major HIV specialist clinic in Hong Kong. HCV genotyping was performed on HCV RNA+ samples. Concurrent STI was defined as the diagnosis of syphilis, gonorrhoea and/or chlamydia within one year of HCV diagnosis. HIV/HCV co‐infected patients with and without concurrent STI were compared in logistic regression models and Mann‐Whitney U in SPSS Statistics.

Results: Between 2004 and 2017, a total of 79 HIV patients were diagnosed with sexually acquired acute HCV infection. All of them were male, 75 (95%) being Chinese, and all except one were MSM. Among 44 cases with known HIV subtype, 31 (70%) were subtype B, 12 (27%) subtype CRF_01AE and one (2%) CRF_07BC. Around 70% (44/60) were infected with HCV genotype 3a, followed by 1a (18%) and 6a (5%). However, only 17 out of 27 HIV subtype B cases were in HCV genotype 3a. Thirty percent of the HCV patients gave a history of recreational use of drug for sex (chem‐fun). Overall 58 (74%) had concurrent STI: 53 (90%) with syphilis only, one (2%) with chlamydia only and five (8%) with multiple STI. HIV + MSM with concurrent STI were more likely to be diagnosed with HIV in the preceding five years (median year of diagnosis: 2013), and had HAART initiated (median year of 2013 vs. 2012) shortly afterwards. HIV + MSM with concurrent STI were more likely to be infected with HCV genotype 3a (80% vs. 53%), the latter forming a monophyletic cluster that has continued to grow. However, HIV subtype, age, year of first HCV positive, time interval between HIV and HCV diagnoses and the history of chem‐fun were not significantly different between the STI+ and STI‐ MSM.

Conclusion: In Hong Kong, HCV and HIV were separately transmitted through sex in co‐infected patients who contracted HIV infection largely within the last five years. Parallel emergence of STI confirmed the extensive practice of condomless sex in the HIV+ MSM community. Chem‐fun was one of the most important associated factors, which explained the clustering of HCV genotype 3a and the concurrent transmission of HCV and syphilis.
All Author(s) ListWong NS, Wong B, Chan D, Lee SS
Name of ConferenceInternational Congress on Drug Therapy in HIV Infection 2018
Start Date of Conference28/10/2018
End Date of Conference31/10/2018
Place of ConferenceGlasgow
Country/Region of ConferenceGreat Britain
Series TitleHIV Glasgow 2018, 28–31 October 2018, Glasgow, UK
Number in SeriesP221
Volume Number21
Issue NumberSuppl 8
LanguagesEnglish-United Kingdom

Last updated on 2021-24-02 at 23:55