Hepatitis C prevalence in HIV infected heterosexual men and men who have sex with men

Background: Globally 1% of individuals are infected with hepatitis C virus (HCV). In South Africa (SA), the prevalence ranges between 0.3% - 1% with few prospective screening data available. Similarly, local data on transmission modes of HCV are limited but probably include parenteral routes and pre-1992 blood or blood product products. The risk of heterosexually transmission is low but is increased in men who have sex with men (MSM) with co- transmission risk of both HIV and HCV. Objectives: Given a limited local understanding, we sought to better understand HCV characteristics and prevalence in 2 groups of HIV-infected men. Methods: HIV positive men in the greater Cape Town metropolitan area were recruited. Sexual orientation was self-identified and demographic and other personal data obtained via a confidentially administered questionnaire. Participants were screened for HCV after a blood draw and positive HCV Ab tests were tested for HCV RNA. Risk factors associated with HCV seropositivity were determined. Results: Five hundred HIV positive men were recruited; 215 (43%) non-MSM and 285 (57%) MSM, with median age 36 years (IQR 20 – 64) and 37 years (IQR 21 – 56), in the MSM and non-MSM group, respectively, p = NS. Overall, 3.4% (n=17) screened HCV positive, 5.6% (n=16) MSM and 0.5% (n=1) non-MSM, with 82.4% viremic for HCV RNA. In respect to genotype (GT) distribution, 50% were infected with GT1, 14.3% GT4 and 35.7% were GT2. In terms of risk, MSM were more likely to have used drugs (54.4% vs. 30.2%, p