Hepatitis C virus (HCV) is highly probable among HIV-negative men who have sex with men with non-injection drug use who are aged 42 and older and use multiple drugs, according to study results published in BMC Infectious Diseases.
Researchers conducted a cross-sectional study to explore the association between non-injection drug use and HCV infection in HIV-negative men who have sex with men who reported non-injection drug use. Data were sourced from the Drugs, AIDS, STDs, and Hepatitis (DASH) project. HIV- and hepatitis B virus-negative adults who self-reported illegal or nonmedically prescribed drug use in the previous 48 hours with the presence of drug metabolites confirmed via urinalysis were recruited from 2 neighborhoods in Houston, Texas between February 2004 and October 2007. Latent Class Analysis (LCA) was used to identify subgroups of drug use patterns and multinomial logistic regression models were used to examine associations between class membership and HCV status, sociodemographic characteristics, sexual behaviors, and sexually transmitted infection (STI) history.
Among 2800 drug users contacted for HIV, HBV, and HCV screening, 1011 (36.1%) had HCV. Of the 273 men who have sex with men who reported non-injection drug use, 40 (14.7%) tested positive for HCV. Age was significantly associated with HCV, with participants aged 42 and older vs those aged younger than 42 exhibiting 2.1 (95% CI, 1.40-3.0) times higher odds of infection.
A total of 118 participants (mean age, 39.6; African American, 83%; bisexual or homosexual, 83%; drug treatment-naïve, 35%) were included in the final analysis, 21 (17.8%) of whom were infected with HCV. Most patients reported ever using more than 2 drugs, the most prevalent types of which were crack cocaine (98%), marijuana (89%), and alcohol (86%).
A 4-class LCA model was selected as the best-fit model. Participants in classes 1 (6.5%), 2 (70.3%), 3 (20.1%), and 4 (3.2%) were those aged 42 and older who used only crack cocaine, those aged approximately 42 who used more than 2 drugs, those aged younger than 42 who used more than 5 drugs, and those aged 42 and older who used more than 6 drugs, respectively.
Only HCV status was significantly related to drug use latent class. After controlling for drug treatment history, self-reported STI history, and trading money or drugs for sex in the past month, the odds of HCV infection in class 4 vs 2 members was nearly 17 times higher (adjusted odds ratio [aOR], 16.9; 95% CI, 1.4-205.4) and almost 22 times higher (aOR, 21.8; 95% CI, 1.5-322.8) in class 4 vs 3 members.
Study limitations include the cross-sectional design, limited sample sizes, potential bias and misclassification of drug use behaviors, potential variability in reports of non-injection drug use, and use of self-reported data.
The study authors concluded, “This study underscores the urgency of addressing HCV infection within the MSM [men who have sex with men] population and offers valuable insights for effective public health interventions.”
By Lisa Kuhns, PhD
References:
Zhao J, Green C, Markham C, Fujimoto K, Nyitray AG, Hwang L-Y. Association between non-injection drug use and hepatitis C infection among HIV-negative men who have sex with men. BMC Infect Dis. 2024;24(1):985. doi:10.1186/s12879-024-09685-3
Source : Infectious Disease Advisor
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