Hepatitis C Virus Infection Trends Among MSM That Attend Clinics for Sexually Transmitted Infections

Hepatitis C virus infection Trends among MSM that attend clinics for sexually transmitted infections: 1995 to 2010 Hepatitis C virus (HCV) has been noted since 2000 as a "sexually-transmitted-infection" (STI) amid MSM that are HIV-positive. This paper seeks to cross-examine the HCV occurrence among MSM attending a big STI-clinic located in Netherlands.

There is need to examine data, and down the time profile, on chronic and acute infection of HCV among the MSM that are both HIV negative and positive, so as to establish the state of the disease and the causes, and to plan how to prevent its spread, in addition to identifying affected cases. In the course of the anonymous cross-sectional surveys that are conducted every two years from 1995 to 2010, people had been interviewed as well as checked for evidence of HCV and HIV antibodies.

There is a standardized questionnaire that has questions to find out about the risk factors for STI and blood-borne infections. 831 HIV-positive MSM participants took part in 19 surveys. It is worth noting that the survey scheduled for the spring of 2004 was not conducted. A set of 54 MSM with insufficient serum samples or lack of it were not included. Seven hundred and seventy-seven MSM were checked for the presence of HCV RNA and HCV antibodies.

Further tests were conducted on MSM that were HIV-negative and were taking part in the survey between 2007 and 2010. More RNA tests on HCV were conducted on all those that were HIV-positive. Antibody testing for HIV in the lab was conducted using a third generation micro-particle EIA (AxSym HCV version 3.0; Abbott Laboratories, Abbott Park, Illinois, USA) that has an immunoblot confirmation feature (Chiron RIBA HCV 3.0 SIA; Ortho-Clinical Diagnostics, Raritan, New Jersey, USA).

HCV infection determinants were examined and analyzed with the logistic regression method with the dates of the calendar year as a continuous variable. Cubic splines (restricted) were used. The statistical package R (V. 2-13.0) was deployed for the analyses. Logistic regression models that were multivariate were developed by the backward step approach and incorporating variables with univariate P value of less than or equal to 0.25 as likely independent determinants. Phylogenetic observation showed signs related to sexual diffusion.

The Results The prevalence of HCV among MSM that were HIV-positive went up by 5.6% as from 1995 and reached the peak in 2008 where it stood at 20.9% in 2007. Fisting was pointed out as one of the strong cause of HCV infection from 2007 to 2008 [Adjusted-Odds-Ratio (AOR) to approx. 2.85, with a 95% confidence interval (or CI) 1.19 and 6.82] compared with the period between 2009 and 2010 (AOR 0.92, 95% CI 0.42 and 2.02). Infection of HCV was independently linked to Chlamydia, bareback anal intercourse, drug use that involves injecting and even old age.

Phylogenetic observations showed a high level of specific clustering of MSM starting the year 2000. Fresh MSM-HCV linkage and the recent discovery of infections of HCV at 0 to 4% suggest a continuous infection trend of the epidemic of HCV amid MSM that are HIV-positive. The prevalence of HCV among MSM that are HIV-negative remained notably low as from 2009 to 2010. It was noted at 0-5%. Discussion & Conclusions It is noted that HCV infection prevalent among MSM that are HIV infected went up in the period culminating in 2007.

There was no evidence of continued infection as from that period onwards. In fact the HCV infection rates have stabilized off late in Amsterdam. This can be associated with a higher level of awareness among MSM. This, in turn, leads to a lower tendency to engage in risky behavior. It could also be the reason for noted early screening practices that encourage treatment. By applying the phylogenetic method, at least five MSM HCV links were noted in circulation among HCV/HIV infested MSM in the city of Amsterdam.

Notably, HIV negative MSM are generally not affected by the outbreak. Over time, the prevalence of HCV among those that are HIV negative stabilized. These were noted to stand at 0.6%. This rate was comparable to the prevalence levels that were observed among the general population in Amsterdam city. Infection of HIV is not a prerequisite for the occurrence of sexually transmitted HCV though. Therefore,.