参加美国 HIV 疫苗试验的男男性行为者和变性女性中丙型肝炎和乙型肝炎感染的发生率和流行率。

Matthew Scherer, Vijay Nandi, Magdalena E Sobieszczyk, Oliver Laeyendecker, Shelly Karuna, Michele Andrasik, Holly E Janes, Erin E Brown, Hong-Van Tieu
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引用次数: 0

摘要

背景:据报道,在男男性行为者 (MSM) 和变性女性 (TGW) 中,丙型肝炎和乙型肝炎病毒(HCV 和 HBV)感染率不断上升。本研究对 2009-2013 年间在美国 18 个城市参加 HIV-1 疫苗试验的 2496 名 18-50 岁有感染 HIV 风险的男男性行为者/变性女性的 HCV 和 HBV 感染情况进行了纵向分析:参与者在 24 个月内完成了行为调查、HIV 检测和采血。在同意接受未来检测的 2397 名参与者中,有 1792 人(74.8%)在基线和稍后的时间点(第 24 个月 [N = 999];如果无法获得,则为第 12 个月 [N = 775] 或第 15 个月 [N=18])获得了配对储存的血液样本:在 1792 名参与者中,98.1% 为 MSM,0.8% 为 TGW,年龄中位数为 30 岁(IQR 为 24 岁至 40 岁)。参与者报告的过去 3 个月内男性性伴侣的中位数为 3 个(IQR 1,5)。55.8%的参与者报告了无套插入式肛交,46.7%的参与者报告了无套接受式肛交。1.3%的人报告使用过注射毒品。在随访期间,1.4% 的人报告使用过暴露前预防疗法 (PrEP)。基线时,11/1792(0.61%)名参与者感染了丙型肝炎病毒(丙型肝炎病毒 AB 阳性,可检测到 RNA),随访时,所有参与者均持续检测到 RNA 并患有慢性丙型肝炎病毒感染。系统发育分析表明,没有出现 HCV 感染集群。8 名参与者的 HCV AB 阳性,但在基线和随访时检测不到 RNA,这代表过去的 HCV 感染已清除;只有 2 人感染了 HCV,并在 12-24 个月内清除。在基线时,2 名参与者(2/1792 = 0.11%)的 HBsAg 呈阳性,表明他们患有慢性 HBV 感染。在 12-24 个月内,4 名参与者(4/1790,0.22%)出现 HBsAg 阳性;这些参与者在基线时 HBcAB 阳性,因此很可能代表重新激活。随访期间没有出现新的 HBV 感染:在参加美国 HIV-1 疫苗试验的 1792 名 18-50 岁有感染 HIV 风险的男男性行为者和变性女性中,丙型肝炎的偶发感染率极低,没有乙型肝炎的偶发感染病例。这些丙型肝炎病毒感染和 HBSAg 阳性的发生率低于之前报告的 MSM/TGW 感染率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence and prevalence of hepatitis C and B infections among men who have sex with men and transgender women enrolled in a United States HIV vaccine trial.

Background: Rising hepatitis C and B virus (HCV and HBV) rates have been reported in men who have sex with men (MSM) and transgender women (TGW). This study characterizes HCV and HBV infections longitudinally among 2,496 MSM/TGW aged 18-50 years and at risk for HIV acquisition enrolled in an HIV-1 vaccine trial in 18 U.S. cities between 2009-2013.

Methods: Participants completed behavioral surveys, HIV testing, and blood collection over 24 months. Of the 2,397 participants who consented for future testing, 1,792 (74.8%) had available paired stored blood samples at baseline and a later timepoint (Month 24 [N = 999]; if unavailable, M12 [N = 775] or M15 [N = 18]).

Results: Among 1,792 participants, 98.1% were MSM, 0.8% were TGW, and the median age was 30 years (IQR 24, 40). Participants reported a median number of 3 male sex partners (IQR 1,5) within the past 3 months. Condomless insertive anal sex was reported by 55.8% and condomless receptive anal sex by 46.7%.1.3% reported injection drug use. During follow-up, 1.4% reported pre-exposure prophylaxis (PrEP) use. At baseline 11/1792 (0.61%) participants had HCV infection (HCV AB positive, RNA detectable), with all having persistent detectable RNA and chronic HCV infection at follow-up. Phylogenetic analysis showed no clusters of HCV infection. 8 participants had HCV AB positive, RNA undetectable at baseline and follow-up, representing past HCV infection with clearance; only 2 acquired HCV, which cleared over 12-24 months. At baseline, 2 participants (2/1792 = 0.11%) had positive HBsAg, indicating chronic HBV infection. Over 12-24 months, 4 (4/1790, 0.22%) developed HBsAg positivity; these participants had HBcAB positivity at baseline, thereby likely representing reactivation. There were no new HBV infections during follow-up.

Conclusion: Among 1,792 men who have sex with men and transgender women aged 18-50 years and at risk for HIV acquisition enrolled in a U.S. HIV-1 vaccine trial, incident hepatitis C infection rates were extremely low, with no cases of incident hepatitis B infection. These rates of incident HCV infection and HBSAg positivity are lower than previously reported among MSM/TGW.

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