Objectives To calculate the rate of hepatitis C virus (HCV) among HIV-infected men who have sex with men (MSM) with no reported history of injection drug use (IDU), and to assess whether disparities exist in HIV/HCV coinfection by race/ethnicity and neighbourhood poverty level within this population in New York City.
Methods HIV-positive men who reported sex with men and did not report IDU at the time of HIV diagnosis, diagnosed through 2015 and alive as of 2000, were matched to people with HCV first reported to the New York City Department of Health and Mental Hygiene between 2000 and 2015. Those with HCV reported before or within 90 days of HIV infection were excluded. A multivariable Cox proportional hazards model was fit to compare the association between HCV diagnosis, race/ethnicity and neighbourhood poverty level.
Results From 2000 to 2015, 54 488 non-IDU MSM were diagnosed with HIV, of whom 2762 (5.1%) were diagnosed with HCV after HIV diagnosis, yielding an overall age-adjusted HCV diagnosis rate of 512 per 100 000 person-years. HIV/HCV coinfection was significantly higher among non-Latino blacks (adjusted HR (aHR)=1.24, 95% CI 1.11 to 1.40) compared with non-Latino whites and among persons living in high-poverty neighbourhoods compared with those in low-poverty neighbourhoods (aHR=1.17, 95% CI 1.01 to 1.35) after stratification by year of HIV diagnosis.
Conclusion Disparities in HIV/HCV coinfection among HIV-positive MSM were observed by race/ethnicity and neighbourhood poverty level. Routine HCV screening is recommended for people infected with HIV. People coinfected with HIV and HCV should be linked to HCV care, treated and cured to reduce morbidity and mortality, and to avoid ongoing HCV transmission.
- hepatitis C
- epidemiology (general)
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Handling editor Anna Maria Geretti
Contributors MSM, AB and AW provided direction for the development of this article and collectively formulated the analysis plan and project proposal for approval by leadership at the New York City Department of Health and Mental Hygiene. MSM communicated with KP and SB to ensure all HIV surveillance data were being properly shared with the Viral Hepatitis Program for this analysis. CMG performed all data cleaning and statistical analyses, and wrote the first draft of this article. KP and SB were consulted for all questions related to the HIV surveillance data. MSM, AB and AN were consulted for all questions related to the statistical methods chosen and used for this project. MSM, KP, SB, AB, AN and AW critically reviewed the first draft of this article and contributed to the writing of later drafts. All authors critically reviewed each edited draft, and read and approved the final manuscript prior to submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval All study procedures were approved by the NYC DOHMH (ID: 17–085) and Columbia University Medical Center (ID: AAR4400) institutional review boards.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available.