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Ferrufino RQ, Bierrenbach AL, Rodrigues C, Figueiredo GM, Gleison D, Yapura S, de Matos MLM, Vasconcelos R, Sol Witkin S, Mendes-Correa MC. The Changing Epidemiology of Hepatitis C Virus Acquisition Among HIV-Infected Individuals in Brazil. AIDS Res Hum Retroviruses 2023; 39:44-49. [PMID: 36301937 PMCID: PMC9889009 DOI: 10.1089/aid.2021.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Identification of mechanisms of hepatitis C virus (HCV) acquisition among HIV-infected people is critical for prevention guidance. The aim of this study was to investigate risk factors for HCV infection and variations in HCV genotype distribution in a cohort of HIV-HCV coinfected patients in Brazil. This was a cross-sectional observational epidemiological study of a cohort of HIV-HCV coinfected individuals seen at a referral center for HIV-infected patients in the city of São Paulo between January and December 2017. The time of HCV acquisition, as determined by chart review, was categorized as before 2000, between 2000 and 2009, and from 2010 onward. HCV genotypes were determined by gene amplification and analysis. Among 3,143 HIV-infected individuals analyzed, 362 (11.5%) were HCV-HIV coinfected. Overall, the reported modes of HCV acquisition were sexual exposure in 172 (47.5%), injection drug use (IDU) in 86 (23.8%), use of inhaled drugs in 67 (18.5%) and blood transfusion in 10 (2.8%) individuals. All individuals who acquired HCV after IDU became infected before 2010. HCV acquisition by sexual contact was reported by 26.4%, 65.9%, and 63.8% of patients before 2000, between 2000 and 2009, and from 2010, respectively. There was an increase (p < .001) in the proportion of cases due to sexual transmission from the period before 2000 (26.4%) to between 2000 and 2009 (65.9%). There was no corresponding increase from 2000 and 2009 to after 2010 (p = .751). HCV genotype 1 was most prevalent at all time periods. The genotype 3 frequency decreased over time (test for trend p < .001), whereas genotype 4, extremely uncommon before 2010, became the second most prevalent genotype from 2010 onward. In HIV-infected individuals in Sao Paulo, Brazil, sexual transmission has replaced IDU as the most frequent mode of HCV acquisition.
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Affiliation(s)
- Rosario Quiroga Ferrufino
- Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, Universidade de São Paulo, Sao Paulo, Brazil
| | | | - Camila Rodrigues
- Faculdade de Medicina, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gerusa Maria Figueiredo
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Faculdade de Medicina, Departamento de Medicina Preventiva, Universidade de São Paulo, Sao Paulo, Brazil
| | - Daniel Gleison
- Faculdade de Medicina, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Silvia Yapura
- Faculdade de Medicina, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Maria Laura Mariano de Matos
- Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, Universidade de São Paulo, Sao Paulo, Brazil
| | - Ricardo Vasconcelos
- Faculdade de Medicina, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Steven Sol Witkin
- Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, Universidade de São Paulo, Sao Paulo, Brazil.,Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, USA
| | - Maria Cássia Mendes-Correa
- Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, Universidade de São Paulo, Sao Paulo, Brazil.,Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Address correspondence to: Maria Cássia Mendes-Correa, Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, n. 470, São Paulo 05403-000, Brazil
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Rönn MM, Ward H. The association between lymphogranuloma venereum and HIV among men who have sex with men: systematic review and meta-analysis. BMC Infect Dis 2011; 11:70. [PMID: 21418569 PMCID: PMC3070636 DOI: 10.1186/1471-2334-11-70] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 03/18/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lymphogranuloma venereum (LGV) is an important re-emerging sexually transmitted infection which is reported to affect particularly HIV-positive men who have sex with men (MSM). The aim of this study is to quantify the association between LGV and HIV in the context of the current emergence of LGV. METHODS A systematic review was performed on the emergence of LGV among MSM since 2000. We report the prevalence of HIV infection from descriptive studies of MSM with LGV, and conduct a meta-analysis to produce a summary estimate of the association between LGV and HIV from case-control studies where cases were MSM with LGV and controls were MSM with rectal chlamydia caused by non-LGV serovars. RESULTS The prevalence of HIV among LGV cases ranges from 67% to 100% in 13 descriptive studies. There is a significant association between HIV and LGV (odds ratio 8.19, 95% CI 4.68-14.33). CONCLUSIONS HIV-positive MSM are disproportionately affected by LGV highlighting the importance of prevention efforts to be targeted to this group. Further research is needed to determine whether the association is due to biological or behavioural factors.
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Affiliation(s)
- Minttu M Rönn
- Department of Infectious Disease Epidemiology, Imperial College London, Old Medical School, St. Mary's Campus, Norfolk Place, Paddington, W2 1PG London, UK
| | - Helen Ward
- Department of Infectious Disease Epidemiology, Imperial College London, Old Medical School, St. Mary's Campus, Norfolk Place, Paddington, W2 1PG London, UK
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