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Changes in the epidemiology of hepatitis C virus co-infection in recent years in the PISCIS HIV Cohort, 1998-2012
ResumenObjectives: Co-infection w ith hepatitis C virus (HCV) is a pressing problem for people living w ith HIV (PLWH). Recent changes in HCV epidemiology and transmission routes and treatment options highlight the need to strengthen current surveillance systems to allow detection of significant changes in incidence. Our objectives are to describe the incidence of HCV infection in the PISCIS Cohort of HIV positive persons to determine w hether anecdotal reports of acute HCV infections in MSM in Catalonia are captured. Methods: The PISCIS Cohort is a multi-centre, observational study of HIV infected individuals aged>16 first follow ed up at fourteen participating hospitals in Catalonia and the Balearic Islands after Jan 1998. Betw een Jan 1998-Dec 2012, 14673 HIV seropositive patients w ere included (73726 person-years of follow -up [PY]). All HCV seronegative patients w ho had >1 follow -up measurement w ere included in this analysis. HCV incidence rates per 100 PY w ere calculated. Results: Of 4258 patients included, transmission group distribution w as: IDU176 (4.15%); 2179 (51.3%), MSM; 1113 (25.9%) heterosexual and 376 (8.7%) unclassified. Over a total of 16480 PY, 271 (6.4%) patients seroconverted, the incidence highest being in IDU, follow ed by MSM and heterosexuals: 8.1, 4.3 and 4.0 per 100 PY, respectively. Incidence declined from 2.6 (95% CI: 1.3-4.6) in 1998-1999 to 1.3 (95% CI: 0.7-2.4) per 100 PY in 2003, thereafter rising steadily to a peak incidence of 2.2 PY (95% CI: 1.4-2.3) in 2012, w hen most incident cases w ere in MSM. Conclusion: HCV incidence in the PISCIS Cohort is primarily driven by IDU, although the steepest rise in incidence in recent years is in MSM, consistent w ith recent reports of acute HCV infections. This study provides further evidence to support improved prevention against HCV infection in PLWH and access to new therapies for HCV infection. (Extraído del document)
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