Article Text
Abstract
Background Hepatitis C virus (HCV) is an increasing health issue among key populations such as men who have sex with men (MSM). We sought to assess the burden of and risk factors for HCV among MSM in Vietnam.
Methods We analysed behavioural and demographic data and stored specimens from MSM surveyed in four provinces through Vietnam's 2009–2010 Integrated Biologic and Behavioural Survey, which used probability-based, respondent-driven sampling. Commercial hepatitis B surface antigen (HBsAg) and HCV/antibody (HCV Ag/Ab) testing were performed on archived sera with follow-up PCR for HCV RNA and genotype determination.
Results Among the 1588 MSM surveyed, the median (range) frequency, by province, of HCV Ag/Ab detection was 28.4% (13.7%–38.8%); 84.5% (83.1%–100%) among HIV-infected and 21.9% (8.9%–28.2%) among HIV-uninfected. HCV prevalence was higher in northern Hanoi and Hai Phong provinces than in southern Ho Chi Minh City and Chan Tho provinces. Among a convenience sample of 67 HCV Ag/Ab+ MSM, 67.2% were HCV RNA+; of 41 genotyped, 73.2% were genotype 1. HBsAg prevalence varied from 8.5% to 27.4%. In the multivariable logistic regression analysis, being HIV-infected (adjusted OR (aOR) 19.0; 7.0–51.9), ever having used injected drugs (aOR 4.4; 1.6–12.4) and age >25 years were significant risk factors for testing HCV Ag/Ab+.
Conclusions HCV infection in Vietnam appears to be high among MSM, particularly among HIV-infected MSM, with a north–south gradient. Given overlapping risk behaviours and associations between HCV and HIV, integrating HIV and HCV programme services to prevent both HIV and HCV transmission among MSM is indicated.
- HEPATITIS C
- HIV
- GAY MEN
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Footnotes
Handling editor Jackie A Cassell
Contributors PN collaborated on study design, acquisition of data, analysis and interpretation of data, drafted the manuscript and provided critical revision of the manuscript. SOC, HD, TH-T and TN collaborated on study design, acquisition of data, interpretation of the data and critically revised the manuscript. ML and JK provided inputs on the analysis design and critical review of the manuscript. TM-H and G-LX collaborated on the interpretation of the data and critical revision of the manuscript.
Funding This research has been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention under the terms of project 5U2GGH000116-03.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Vietnam National Institute of Hygiene and Epidemiology (NIHE) Ethics Review Board (IRB00010241) and the Institutional Review Board of the U.S. Centers for Disease Control and Prevention (CDC) (protocol #5395).
Provenance and peer review Not commissioned; externally peer reviewed.