The Vanguard Project:

This was presented as a poster at the 11th Annual Canadian Conference on HIV/AIDS Research in Winnipeg in April 2002.

Factors associated with hepatitis C virus (HCV) infection in a cohort of men who have sex with men

Kevin JP Craib, Keith Chan, Steve Martindale, Mary Lou Miller, Robert S. Hogg

The Vanguard Project, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC.

OBJECTIVES:

To determine the prevalence of HCV infection and identify factors associated with HCV infection in a cohort of gay men in Vancouver, B.C.

METHOD:

The Vanguard Project (VP) is a prospective study of gay and bisexual men living in the Greater Vancouver region. Participants were recruited through outreach, medical clinics, and physicians' offices. The most recent blood specimen (obtained during August 1997- April 2001) from each of 200 VP participants was tested for HCV antibody. Data regarding demographic variables, injection drug use, and sex trade involvement were obtained from self-administered questionnaires. Comparisons between HCV-positive and HCV-negative men were conducted..

RESULTS:

A total of 16 of 200 participants (8.0%) were identified as HCV-positive. HCV prevalence was significantly higher among HIV-positive men compared to HIV-negative men (11/26=42.3% vs. 5/173=2.9%; p<0.001). HCV-positive and HCV-negative men were similar with respect to median age (27 vs. 28 years; p=0.410). Compared to HCV-negative men, HCV positive men were more likely to be HIV-positive (69% vs. 8%, p<0.001), use injection drugs (81% vs. 8%, p<0.001), be aboriginal (44% vs. 8%, p<0.001), live in unstable housing (46% vs. 5%, p<0.001), have less than a high school education (53% vs. 11%, p<0.001), have sold sex in the past year (63% vs. 11%, p<0.001), or in their lifetime (94% vs. 24%, p<0.001). One of 16 HCV-positive men (6.3%) did not report any injection drug use.

CONCLUSIONS:

The majority of HCV infections in this cohort were attributable to injection drug use. Sexual transmission appears to be an inefficient route of HCV transmission in this cohort.