Hepatitis C virus (HCV) infection has been increasingly
recognized among HIV-infected men who have sex with men (MSM) worldwide. We
investigated the trend of and factors associated with acute hepatitis C (AHC)
among HIV-infected individuals in Taiwan.
The
National Disease Surveillance System collects characteristics of AHC, HIV,
syphilis, and gonorrhea cases through mandatory reports and patient interviews.
Reported AHC patients in 2014 were interviewed additionally on sexual and
parenteral exposures. Information on HCV genotypes were collected from the
largest medical center serving HIV-infected Taiwanese. We defined an HIV/AHC
case as a documented negative HCV antibody test result followed within 12
months by a positive test in a previously reported HIV-infected individual.
Each case was matched to two HIV-infected, non-AHC controls for age, age of HIV
diagnosis, sex, transmission route, HIV diagnosis date, and county/city.
Conditional logistic regression was used to identify associated
characteristics.
During
2001–2014, 93 of 6,624 AHC reports were HIV/AHC cases; the annual case count
increased from one in 2009 to 34 in 2014. All were males (81 [87%] MSM) aged
21–49 years with AHC diagnosed 2–5,923 days after HIV diagnoses. Sixty-eight
(73%) lived in the Taipei metropolitan area. Detected HCV genotypes were 2a (n
= 6), 1b (n = 5), 1b + 2a (n = 1) and 2b (n = 1). Among 28 HIV/AHC patients
interviewed in 2014, 13 (46%) reported engaging in unprotected sex ≤3 months
before AHC diagnosis. Seventy-nine HIV/AHC cases were matched to 158 controls.
HIV/AHC was associated with recent syphilis (adjusted odds ratio [aOR], 10.9;
95% confidence interval [CI], 4.2–28.6) and last syphilis >6 months (aOR,
2.9; 95% CI, 1.2–6.9).
HIV/AHC cases continued to increase particularly among
sexually active HIV-infected MSM with a syphilis diagnosis in northern Taiwan.
We recommend surveillance of associated behavioral and virologic
characteristics and HCV counseling and testing for HIV-infected men in Taiwan.
Below: Proportion of HIV/AHC cases among AHC cases with documented HCV seroconversion, Taiwan, 2001–2014
Below: Trend of HIV/AHC cases by population at risk, Taiwan, 2001–2014
Below: Number of HIV/AHC cases in each county and city, Taiwan, 2001–2014
Numbers in the map indicate numbers of HIV/AHC cases in each city or county
Full article at: http://goo.gl/0HFNZa
By:
Yi-Chun Lo, Jen-Hsiang Chuang
Taiwan Centers for Disease Control, Taipei, Taiwan
Yi-Chun Lo, Hsin-Yun Sun, Chien-Ching Hung
Department of Internal Medicine, National Taiwan University
Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Mao-Song Tsai
Department of Internal Medicine, Far Eastern Memorial
Hospital, New Taipei City, Taiwan
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