Incidence of HCV Reinfection Among HIV-Positive MSM and Its Association With Sexual Risk Behavior: A Longitudinal Analysis
Astrid M. Newsum, Amy Matser, Janke Schinkel, Marc van der Valk, Kees Brinkman, Arne van Eeden, Fanny N. Lauw, Bart Rijnders, Thijs van de Laar, Marita van de Kerkhof, Colette Smit, Anders Boyd, Joop E. Arends, Maria Prins, MSM Observational Study of Acute Infection with hepatitis C (MOSAIC) study group, Haggai Eden, Jan T. M. van der Meer, Richard Molenkamp, F J J Pijnappel, H. W. Reesink, Janke Schinkel, Gaby S. Steba, Marc van der Valk, G.E.L. van den Berk, K Brinkman, Imke Hooijenga, David Kwa, Narda van der Meche, A.J.M. Toonen, D. Vos, Marjolein van Broekhuizen, Fanny N. Lauw, Jan W. Mulder, Joop E. Arends, Andrew Van Kessel, Bianca Silvius, Miranda Versloot, André Boonstra, Bart Rijnders, W. Brokking, Arne van Eeden, L. Elsenburg, H. Nobel, Thijs van de Laar, Colette Smit, Astrid M. Newsum, Maria Prins, Wendy van der Veldt
Abstract
BACKGROUND: Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV) reinfection following clearance of HCV, but risk factors specifically for reinfection have never been comprehensively assessed. METHODS: Using data from a prospective observational cohort study among HIV-positive MSM with an acute HCV infection (MOSAIC), the incidence of HCV reinfection following spontaneous clearance or successful treatment was assessed. A univariable Bayesian exponential survival model was used to identify risk factors associated with HCV reinfection. RESULTS: In total, 122 HIV-positive MSM who had a spontaneously cleared or successfully treated HCV infection between 2003 and 2017 were included. During a median follow-up of 1.4 years (interquartile range [IQR] 0.5-3.8), 34 HCV reinfections were observed in 28 patients. The incidence of HCV reinfection was 11.5/100 person-years and among those with reinfection, median time to reinfection was 1.3 years (IQR 0.6-2.7). HCV reinfection was associated with receptive condomless anal intercourse, sharing of sex toys, group sex, anal rinsing before sex, ≥10 casual sex partners in the last 6 months, nadir CD4 cell count <200 cells/mm3, and recent CD4 cell count <500 cells/mm3. CONCLUSIONS: Incidence of HCV reinfection was high and strongly associated with sexual risk behavior, highlighting the need for interventions to reduce risk behavior and prevent HCV reinfections among HIV-positive MSM.