Higher Risk of Incident Hepatitis C Virus Coinfection Among Men Who Have Sex With Men, in Whom the HIV Genetic Bottleneck at Transmission Was Wide

Publication

Higher Risk of Incident Hepatitis C Virus Coinfection Among Men Who Have Sex With Men, in Whom the HIV Genetic Bottleneck at Transmission Was Wide

Journal Paper/Review - Jun 18, 2014

Kouyos Roger D, Ledergerber Bruno, Bernasconi Enos, Vernazza Pietro, Battegay Manuel, Cavassini Matthias, Calmy Alexandra, Kovari Helen, Shah Cyril, Aubert Vincent, Klimkait Thomas, Yerly Sabine, Böni Jürg, Yang Wan-Lin, Braun Dominique L, Rauch Andri, Günthard Huldrych F

Citation

Kouyos R, Ledergerber B, Bernasconi E, Vernazza P, Battegay M, Cavassini M, Calmy A, Kovari H, Shah C, Aubert V, Klimkait T, Yerly S, Böni J, Yang W, Braun D, Rauch A, Günthard H. Higher Risk of Incident Hepatitis C Virus Coinfection Among Men Who Have Sex With Men, in Whom the HIV Genetic Bottleneck at Transmission Was Wide. J Infect Dis 2014; 210:1555-61.

Type

Journal Paper/Review (English)

Journal

J Infect Dis 2014; 210

Publication Date

Jun 18, 2014

Issn Electronic

1537-6613

Pages

1555-61

Brief description/objective

BACKGROUND
High-risk sexual behaviors have been suggested as drivers of the recent dramatic increase of sexually transmitted hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM).

METHODS
We assessed the association between the genetic bottleneck of HIV at transmission and the prevalence and incidence of HCV coinfection in HIV-infected MSM from the Swiss HIV Cohort Study (SHCS). As a proxy for the width of the transmission bottleneck, we used the fraction of ambiguous nucleotides detected by genotypic resistance tests sampled during early HIV infection. We defined a broad bottleneck as a fraction of ambiguous nucleotides exceeding a previously established threshold (0.5%).

RESULTS
From the SHCS, we identified 671 MSM with available results of HCV serologic tests and with an HIV genotypic resistance test performed during early HIV infection. Of those, 161 (24.0%) exhibited a broad HIV transmission bottleneck, 38 (5.7%) had at least 1 positive HCV test result, and 26 (3.9%) had an incident HCV infection. Individuals with broad HIV transmission bottlenecks exhibited a 2-fold higher odds of having ever experienced an HCV coinfection (odds ratio, 2.2 [95% confidence interval {CI}, 1.1-4.3]) and a 3-fold higher hazard of having an incident HCV infection (hazard ratio, 3.0 [95% CI, 1.4-6.6]) than individuals with narrow HIV transmission bottlenecks.

CONCLUSIONS
Our results indicate that the currently occurring sexual spread of HCV is focused on MSM who are prone to exhibit broad HIV transmission bottlenecks. This is consistent with an important role of high-risk behavior and mucosal barrier impairment in the transmission of HCV among MSM.