Journal Article Ahead of print
PubMed: 42682263 DOI: 10.1097/QAD.0000000000004614
Clinical phenotypes and incidence of acute or recent hepatitis C virus infection and bacterial sexually transmitted infections among MSM with HIV.
AIDS
Authors: Juan Berenguer, Pablo Ryan, Luis Ramos-Ruperto, Luz Martín-Carbonero, Leire Pérez-Latorre, Ignacio De Los Santos, Adriana Pinto, María J Vivancos, Eva Orviz, Beatriz Álvarez, José Sanz, Pilar Ruiz-Seco, Rafael Torres, Marta De Miguel, Herminia Esteban, Inmaculada Jarrín, Salvador Resino, José M Bellón, Juan González-García
Affiliations
- Hospital General Universitario Gregorio Marañón.
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM).
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC).
- Hospital Universitario Infanta Leonor.
- Grupo de Estudio de Infecciones de transmisión sexual de SEIMC (GEITS).
- Hospital Universitario La Paz.
- Instituto de Investigación Sanitaria Hospital La Paz (IdiPAZ).
- Hospital Universitario de la Princesa.
- Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-PRINCESA).
- Hospital Universitario 12 de Octubre.
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (I+12).
- Hospital Universitario Ramón y Cajal.
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS).
- Hospital Clínico San Carlos.
- Instituto de Investigación Sanitaria del Hospital Clínico de San Carlos (IdISSC).
- Hospital Universitario Fundación Jiménez Díaz, Madrid.
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares.
- Hospital Universitario Infanta Sofía (FIIB HUIS-HUHEN), San Sebastián de los Reyes.
- Universidad Europea de Madrid, Madrid.
- Hospital Universitario Severo Ochoa, Leganés.
- Fundación SEIMC-GeSIDA.
- Centro Nacional de Epidemiología - Instituto de Salud Carlos III (ISCIII), Madrid.
- Centro Nacional de Microbiología - Instituto de Salud Carlos III (ISCIII), Majadahonda, Spain.
Abstract
OBJECTIVE
Risk of acute/recent hepatitis C virus infection (ARHCV) and bacterial sexually transmitted infections (STIs) among MSM (MSM-HIV) is heterogeneous. We aimed to identify clinical phenotypes and assess their association with incident ARHCV and bacterial STIs.
DESIGN
A prospective multicenter cohort study.
METHODS
Between 2022 and 2024, MSM-HIV were recruited from 10 centers in Madrid and followed for 12 months with HCV and bacterial STI screening. App-based questionnaires captured behavioral and mental health data. Thirty-eight variables were analyzed using principal component analysis and hierarchical clustering to derive clinical phenotypes.
RESULTS
A total of 529 participants were included (median age 41 years). Three phenotypes were identified: CP1 (n = 328, 62.0%), CP2 (n = 133, 25.1%), and CP3 (n = 68, 12.9%), representing different levels of sexual risk, substance use, and prior STI/HCV history. ARHCV incidence was 0.94, 0.72, and 11.76 per 100 person-years in CP1, CP2, and CP3, respectively, and was higher in CP3 than in CP1 (incidence rate ratio [IRR] 12.49, 95% confidence interval [CI] 3.00-73.08) and CP2 (16.25, 2.18-720.93). Bacterial STI incidence was 33.29, 60.83, and 61.76 per 100 person-years, respectively, and was higher in CP2 (IRR 1.83, 95% CI 1.36-2.46) and CP3 (IRR 1.86, 95% CI 1.27-2.68) than in CP1.
CONCLUSION
Clinical phenotypes stratified ARHCV and bacterial STI incidence among MSM-HIV. ARHCV was concentrated in a small high-exposure subgroup, whereas bacterial STIs were more frequent in intermediate and high-exposure phenotypes. Phenotype-based approaches may help guide risk stratification and prevention in HIV care.
MeSH
Sexually Transmitted Diseases, Hepatitis C, Incidence, Phenotype, Acquired Immunodeficiency Syndrome, Hiv, Viruses, Infections, Hepatitis, Virus Diseases