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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

Roger D. Kouyos, Andri Rauch, Dominique L. Braun, Wan-Lin Yang, Jürg Böni, Sabine Yerly, Thomas Klimkait, Vincent Aubert, Cyril Shah, Helen Kovari, Alexandra Calmy, Matthias Cavassini (+5 others)
2014 Journal of Infectious Diseases  

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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
more » ... 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.
doi:10.1093/infdis/jiu315 pmid:24943723 fatcat:firzxjwkqzhw3eynpjn6scc25u
Citation

Roger D. Kouyos, Andri Rauch, Dominique L. Braun, Wan-Lin Yang, Jürg Böni, Sabine Yerly, Thomas Klimkait, Vincent Aubert, Cyril Shah, Helen Kovari, Alexandra Calmy, Matthias Cavassini, Manuel Battegay, Pietro L. Vernazza, Enos Bernasconi, Bruno Ledergerber, Huldrych F. Günthard. "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 of Infectious Diseases 210.10 (2014) 1555-1561