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Trouble with bleeding: risk factors for acute hepatitis C among HIV-positive gay men from Germany--a case-control

Axel J Schmidt1, Jürgen K Rockstroh, Martin Vogel

  • 1Department for Infectious Diseases Epidemiology, Robert Koch Institute, Berlin, Germany. a.j.schmidt@rki.de

Plos One
|March 17, 2011
PubMed
Abstract

Insights

Hepatitis C risk factors in HIV-positive men who have sex with men include sexual practices causing rectal bleeding and drug snorting. Sharing equipment and partners may facilitate sexual transmission.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Sexual Health

Background:

  • Hepatitis C virus (HCV) outbreaks are increasing among HIV-positive men who have sex with men (MSM).
  • Understanding the sexual transmission of HCV in this population is crucial.

Purpose of the Study:

  • To identify risk factors for hepatitis C among HIV-positive MSM.
  • Focus on sexual, nosocomial, and non-sexual determinants of HCV infection.

Main Methods:

  • A case-control study embedded within a behavioral survey of MSM in Germany (2006-2008).
  • Cases were HIV-positive, acutely HCV-co-infected MSM without injection drug use history.
  • Controls were HIV-positive MSM without known HCV infection, matched for age.

Main Results:

  • Independent risk factors included sex-associated rectal bleeding, receptive fisting, and cocaine/amphetamine snorting with group sex.
  • Surgical interventions among cases were associated with sex-associated rectal bleeding.

Conclusions:

  • Rectal bleeding during sexual activity and drug snorting in high-prevalence settings are key risk factors for acute hepatitis C.
  • Sharing snorting equipment and sexual partners may be transmission routes.
  • Public health efforts should address blood exposure in sexual behaviors among HIV-positive MSM.

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