The Hepatitis C Epidemic Among HIV-Positive MSM: Incidence Estimates From 1990 to 2007
In the current study, the authors estimated hepatitis C virus incidence among HIV-infected men who have sex with men, 1990-2007, using data from 12 cohorts from the Concerted Action on Seroconversion to AIDS and Death in Europe Collaboration. Estimates were based on standard incidence methods and methods for interval-censored data, taking into account that routine HCV data collection began in different calendar years in the cohorts.
Of 4,724 MSM with an HCV test included, 124 (4 percent) had only positive test results, 2,798 (93 percent) had only negative and 92 (3 percent) had both. HCV incidence in 1990 ranged from 0.9 to 2.2 per 1,000 person-years, depending on the analysis strategy. Incidence increased through 1995, when it ranged from an estimated 5.5 and 8.1 per 1,000 person-years. Substantial increases occurred from 2002 on, with incidence ranging between 16.8 and 30.0 per 1,000 person-years in 2005 and between 23.4 and 51.1 per 1,000 person-years in 2007.
"Our data support phylodynamic findings that HCV incidence had already increased among HIV-infected MSM from the mid-1990s," the authors concluded. "However, the main expansion of the HCV epidemic started after 2002. Incidence estimates obtained from cohort studies may help identify changes in the spread of important infections earlier and should guide routine testing policies to minimize further disease burden."