Modifiable Risk Factors for Hepatitis C Virus Coinfection among HIV-positive Men Who Have Sex Men at Île-de-France: Need for Innovative Harm Reduction Micro-Elimination Strategies (ANRS 9520 DRIVER)

Abstract Background Since the last decade, prevalence of hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). We aimed to assess the prevalence of HCV coinfection in HIV-positive MSM and identify associated factors in Île-de-France Method This was a multicentric study conducted among HIV-positive MSM seen at least once between 2015 and 2017 HIV clinics of Ile-de-France. Clinical data using CRF, sociodemographic and behavioral data including sexual practices using self-administered questionnaire were collected. All the participants were screened for viral hepatitis including HCV infection. Multivariable logistic regression was used to identify factors associated with HCV co-infection Result In this study, 781 HIV-positive MSM were included with a mean age of 46.76 years (Standard Deviation [SD] = 10.94) and the mean time since HIV diagnosis was 13.93 ± 9.43 years. Of them, 77 participants were infected with HCV with a prevalence of 9.9%; (95% confidence intervals (CI) 7.9% – 12.2%). In multivariable analysis, after adjustment for time since HIV diagnosis and history of anal proctitis, history of GHB (aOR 3.53 [95%CI] [1.89;6.58], p < 0.001) or amphetamine (4.72 [2.05;10.85], p < 0.001) consumption, active syphilis infection (3.22 [1.08;9.54], p = 0.035), sensation seeking behavior (“My sexual partners must think that I’m a risk taker” (1.90 [1.04;3.48], p = 0.037)) and risk behavior at sexual intercourses in group ([2.01 [1.05;3.82], p = 0.034) were shown to have significant effect on HCV acquisition. Conclusion: This showed high prevalence of HCV infection among HIV-positive MSM in Île-de-France, suggesting the need for not only systematic screening for HCV, but also for a HCV micro-elimination among this vulnerable subgroup.