Are we on the precipice of a new epidemic? Risk for hepatitis C among HIV-negative men-, trans women-, and trans men- who have sex with men in the United States

ABSTRACT

Emerging data from Europe have documented increases in diagnoses of acute hepatitis C virus (HCV) infection among HIV-negative men who have sex with men. We investigated risk factors for HCV and their correlates in the Together 5000 study, a U.S. national cohort study of HIV-negative men (n = 6089), transgender women (n = 40), and transgender men (n = 42) who have sex with men. We used bivariate and multivariable analyses to determine demographic and behavioral factors associated with high risk for acute HCV infection (using the HCV-MOSAIC risk indicator with a score ≥ 2.0). Mean HCV risk score was 1.38 (SD = 1.09) and 27.3% of participants had HCV risk scores ≥ 2.0. In multivariable modeling, being cisgender male (vs. not) was associated with having a lower HCV-MOSAIC risk score. Meanwhile, being white, having been incarcerated, prior use of HIV pre- or post-exposure prophylaxis, having ever been tested for HIV, and recent methamphetamine use were associated with high risk for HCV. More than one-in-four participants exceeded the threshold score for HCV risk. Those with high HCV-MOSAIC risk scores were more likely to have been in settings where they could be tested for acute HCV (i.e., HIV testing, PrEP care, PEP care, incarceration), suggesting opportunities to engage them in HCV screening, prevention, and treatment.

KEYWORDS:

• Acute hepatitis C
• HIV risk
• men who have sex with men (MSM)
• gay and bisexual men
• transgender men
• transgender women

Acknowledgements

Special thanks to additional members of the T5K study team: Sarit A. Golub, Gregorio Millett, Don Hoover, Viraj V. Patel, David W. Pantalone, Sarah Kulkarni, Matthew Stief, Chloe Mirzayi, Alexa D’Angelo, Gloria Perez, Corey Morrison, Pedro Carneiro, & Javier Lopez-Rios. Thank you to the program staff at NIH: Gerald Sharp, Sonia Lee, and Michael Stirratt. And thank you to the members of our Scientific Advisory Board: Michael Camacho, Demetre Daskalakis, Sabina Hirshfield, Jeremiah Johnson, Claude Mellins, and Milo Santos. Finally, this work would not be possible without the participation T5K cohort members. This paper was previously presented at the 2019 AIDS Impact conference in London, UK (July 28-30).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Together 5000 was funded by the National Institutes for Health [UG3/UH3 AI 133675 – PI Grov]. Other forms of support include the CUNY Institute for Implementation Science in Population Health, and the Einstein, Rockefeller, CUNY Center for AIDS Research [ERC CFAR, P30 AI124414].