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Hepatitis C virus infection in a male homosexual cohort: risk factor analysis
O K Ndimbie1, L A Kingsley, S Nedjar
1Department of Pathology, University of Pittsburgh, PA.
Insights
Hepatitis C virus (HCV) infection is linked to specific sexual behaviors in homosexual men. Identifying these practices is crucial for preventing HCV transmission in at-risk populations.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Hepatitis C virus (HCV) infection poses a significant global health burden, primarily transmitted through parenteral exposure.
- Sexual transmission of HCV is increasingly recognized, particularly within specific populations like homosexual men.
Purpose of the Study:
- To identify specific sexual practices and sexually transmitted diseases (STDs) associated with HCV infection in homosexual men.
- To inform targeted public health interventions aimed at reducing HCV incidence.
Main Methods:
- Analysis of social and medical histories of 1058 homosexual men from the Multicenter AIDS Cohort Study.
- Multivariate analysis to determine risk factors for HCV seropositivity.
Main Results:
- HCV seropositivity was found in 2.9% of participants, with a higher co-infection rate in HIV-positive individuals.
- Key risk factors included needle sharing, illegal drug use, a history of syphilis, rectal gonorrhea, anal intercourse with ejaculation, and pre-intercourse enema use.
- The number of sexual partners was not a significant risk factor for HCV infection.
Conclusions:
- HCV infection in homosexual men is associated with specific STDs and sexual behaviors.
- Educational initiatives should incorporate findings on high-risk behaviors to mitigate STD and HCV incidence.
Background:
Hepatitis C virus (HCV) infection is a major cause of morbidity throughout the world. Parenteral exposure to infected blood accounts for the majority of cases. Sexual transmission is suggested by the higher prevalence of infection in sex workers and homosexual men. Sexual practices which contribute to HCV infection need to be identified.
Methods:
The social and medical history, and HCV serostatus of 1058 homosexual men in the Pittsburgh arm of the Multicenter AIDS Cohort Study were analysed. Multivariate analysis was used to determine risk factors for HCV seropositivity.
Results:
31 men were HCV seropositive by enzyme immunoassay and recombinant immunoblot assay (2.9%). They were more likely to be HIV seropositive (39%) than the HCV seronegative men (19%). Needle sharing and illegal drug use were the most important risk factors for HCV seropositivity. Statistically significant sexual factors (p < 0.05) included a history of syphilis, rectal gonorrhea, anal insertive intercourse with ejaculation, and douche or enema use before anal receptive intercourse. The number of sexual partners was not a significant risk factor.
Conclusions:
HCV infection is associated with specific sexually transmitted diseases (STDs) and sexual practices in the male homosexual population. The evidence of high risk behavior should be incorporated into ongoing educational efforts to decrease the incidence of STDs.