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Incidence and Risk Factors for Incident Hepatitis C Infection Among Men Who Have Sex With Men With HIV-1 Infection in a Large Urban HIV Clinic in Tokyo

Nishijima, Takeshi MD*,†; Shimbo, Takuro MD, PhD; Komatsu, Hirokazu MD, PhD§; Hamada, Yohei MD*; Gatanaga, Hiroyuki MD, PhD*,†; Oka, Shinichi MD, PhD*,†

JAIDS Journal of Acquired Immune Deficiency Syndromes: February 1st, 2014 - Volume 65 - Issue 2 - p 213–217
doi: 10.1097/QAI.0000000000000044
Brief Report: Clinical Science

Background: The epidemiology of hepatitis C virus (HCV) infection among HIV-infected men who have sex with men (MSM) who do not inject drugs in Asia remains unknown.

Method: The incidence and risk factors for incident HCV infection among HIV-infected MSM at a large HIV clinic in Tokyo were elucidated. Poisson regression compared the incidence of HCV seroconversion at different observation periods.

Results: Of 753 HIV-1 infected MSM patients negative for HCV antibody (HCVAb) at baseline and available follow-up HCVAb test, 21 patients (2.8%) seroconverted to HCVAb positive over 2246 person-years (PY), for an incidence of 9.35 per 1000 PY. The incidence increased over time from 0 per 1000 PY in 2005–2006, 3.0 per 1000 PY in 2007–2008, 7.7 per 1000 PY in 2009–2010, to 24.9 per 1000 PY in 2011–2012 (P = 0.012). Of 21 incident cases, only 4 (19%) were injection drug users, and sensitivity analysis that excluded injection drug users yielded similar findings. Multivariate analysis identified illicit drug use to be an independent risk for HCV infection (hazard ratio = 3.006; 95% confidence interval: 1.092 to 8.275; P = 0.033).

Conclusions: Incident HCV infection is increasing among HIV-1-infected MSM noninjection drug users at resource-rich setting in Asia. Illicit drug use is an independent risk factor for incident HCV infection in this population.

Supplemental Digital Content is Available in the Text.

*AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan;

Center for AIDS Research, Kumamoto University, Kumamoto, Japan;

Department of Clinical Study and Informatics, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; and

§Department of Community Care, Saku Central Hospital, Nagano, Japan.

Correspondence to: Hiroyuki Gatanaga, MD, PhD, AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo 162-0052, Japan (e-mail:

Supported by a Grant-in Aid for AIDS research from the Japanese Ministry of Health, Labour, and Welfare (Grant H23-AIDS-001).

Study design: T.N., T.S., H.K., and Y.H.; data collection: T.N. and H.G.; data interpretation: T.N., T.S., and H.K.; and drafting and critical revision of manuscript: T.N., H.G., and S.O. All authors have read and approved the text submitted.

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received July 03, 2013

Accepted October 22, 2013

© 2014 by Lippincott Williams & Wilkins