Changing seroprevalence of hepatitis C virus infection among HIV-positive patients in Taiwan.

Chia-Wen Li, Chia-Jui Yang, Hsin-Yun Sun, Mao-Song Tsai, Shih-Ping Lin, Te-Yu Lin, Chien-Yu Cheng, Yi-Chien Lee, Yu-Shan Huang, Chun-Eng Liu, Yuan-Ti Lee, Hung-Jen Tang, Ning-Chi Wang, Shu-Hsing Cheng, Wen-Chien Ko, Chien-Ching Hung

Journal: PloS one 2018;13(3):e0194149

PMID: 29547628

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Abstract

OBJECTIVE

The study aimed to describe the evolution of the seroprevalence of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-positive patients included in two cohorts in Taiwan.

METHODS

We retrospectively collected the information on demographic and clinical characteristics of 4,025 and 3,856 HIV-positive Taiwanese, who were aged 18 years or older at designated hospitals around Taiwan in 2004-2007, when an outbreak of HIV infection was occurring, and 2012-2016, when the outbreak was controlled with the implementation of harm reduction program, respectively. Comparisons of HCV seropositivity were made among different age and risk groups for HIV transmission between these two cohorts.

RESULTS

The overall HCV seroprevalence of the 2004-2007 cohort and 2012-2016 cohort was 43.4% (1,288/2,974) and 18.6% (707/3,793), respectively (P<0.001). The HCV seroprevalence among injecting drug users (IDUs), though decreasing, was constantly high across the two cohorts, 96.4% and 94.0% (P = 0.02), respectively, and all age groups. In contrast, the corresponding figures among men who have sex with men (MSM) and heterosexuals in the two cohorts were 5.9% vs. 3.5% (P = 0.002) and 9.4% vs. 10.9% (P = 0.59), respectively. Among sexually transmitted HIV-positive patients, HCV seropositivity was significantly correlated with age (adjusted odds ratio [aOR], per 1-year increase, 1.03; 95% confidence interval [CI], 1.02-1.05) and a rapid plasma reagin (RPR) titer ≥1:8 (aOR, 1.58; 95% CI, 1.03-2.43) in a multivariate analysis including age, gender, route for HIV transmission, baseline CD4 count and plasma HIV RNA load, the presence of hepatitis B surface antigen, and an RPR titer ≥1:8. Compared with heterosexuals, the aOR for HCV seropositivity among MSM was 0.47 (95% CI, 0.31-0.72).

CONCLUSIONS

HCV seroprevalence among HIV-positive patients in Taiwan decreased with time, probably related to the inclusion of younger adults and more non-IDUs, and remained high among IDUs. HCV seropositivity was associated with age and an RPR titer ≥1:8 among patients who acquired HIV through sexual contact.

Address: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.; School of Medicine, National Yang-Ming University, Taipei, Taiwan.; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.; Department of Internal Medicine, Catholic Fu-Jen Medical College, New Taipei City, Taiwan.; Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.; Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.; School of Public Health, National Yang-Ming University, Taipei, Taiwan.; Department of Internal Medicine, Catholic Fu-Jen Medical College, New Taipei City, Taiwan.; Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.; Department of Health and Nutrition, Chia Nan University of Pharmacy and Sciences, Tainan, Taiwan.; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.; School of Public Health, Taipei Medical University, Taipei, Taiwan.; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.; China Medical University, Taichung, Taiwan.

DOI: 10.1371/journal.pone.0194149

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MeSH Terms: Adolescent, Adult, Age Factors, Aged, Coinfection, Female, HIV Infections, HIV Seroprevalence, HIV-1, Hepacivirus, Hepatitis C, Heterosexuality, Humans, Male, Middle Aged, Retrospective Studies, Sexual and Gender Minorities, Taiwan