HEPATITIS-C VIRUS-INFECTION IN A MALE-HOMOSEXUAL COHORT - RISK FACTOR-ANALYSIS

Background: Hepatitis C virus (HCV) infection is a major cause of morb idity throughout the world. Parenteral exposure to infected blood acco unts for the majority of cases. Sexual transmission is suggested by th e higher prevalence of infection in sex workers and homosexual men. Se xual practices which contribute to HCV infection need to be identified . Methods: The social and medical history, and HCV serostatus of 1058 homosexual men in the Pittsburgh arm of the Multicenter AIDS Cohort St udy were analysed. Multivariate analysis was used to determine risk fa ctors for HCV seropositivity. Results: 31 men were HCV seropositive by enzyme immunoassay and recombinant immunoblot assay (2.9%). They were more likely to be HIV seropositive (39%) than the HCV seronegative me n (19%). Needle sharing and illegal drug use were the most important r isk factors for HCV seropositivity. Statistically significant sexual f actors (p < 0.05) included a history of syphilis, rectal gonorrhea, an al insertive intercourse with ejaculation, and douche or enema use bef ore anal receptive intercourse. The number of sexual partners was not a significant risk factor. Conclusions: HCV infection is associated wi th specific sexually transmitted diseases (STDs) and sexual practices in the male homosexual population. The evidence of high risk behavior should be incorporated into ongoing educational efforts to decrease th e incidence of STDs.