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Risk Factors for Hepatitis C Transmission in HIV Patients, Hepacam Study, ANRS 12267 Cambodia

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Abstract

In 2009, we conducted a case–control study to explore the routes of HCV transmission in people living with HIV/AIDS (PLHIV) in Cambodia. Cases were HCV/HIV co-infected patients (who tested RT-PCR positive for HCV-RNA or had confirmed presence of HCV antibodies) (n = 44). Controls were HIV mono-infected patients, with no HCV antibodies (n = 160). They were recruited among the PLHIV presenting at one national reference centre of HIV/AIDS. Multivariate analysis showed that factors associated with the co-infection were the age older than 50 years (OR 5.4, 95 % confidence interval (CI) 1.5–19.6), the exposure to multiple parenteral infusions before the year 2000 (OR 3.4, 95 % CI 1.5–7.6), to surgery (OR 2.6, 95 % CI 1.2–5.7) and to fibroscopy (OR 2.4, 95 % CI 1.0–5.7). These results show the need to implement HCV screening in PLHIV, to support the implementation of national infection control guidelines, and to reinforce public awareness on the risks linked to parenteral medications.

Resumen

En 2009 condujimos un investigación de casos y controles para estudiar las rutas de transmisión del VHC (virus de la hepatitis C) en la población camboyana con VIH/SIDA (PLWHA, personas viviendo con el virus del VIH/SIDA). Los casos (44 individuos) eran pacientes co-infectados con VHC/VIH, con resultados positivos para RNA-VHC en RT-PCR, o con presencia confirmada de anticuerpos contra el virus VHC. Los controles (160 individuos) fueron pacientes con VIH y ausencia de anticuerpos contra VHC. Los pacientes coinfectados con VIH/VHC (PLWHA) fueron reclutados en un centro nacional de referencia en VIH/SIDA, el Hospital Calmette in Phnom Penh. El análisis multivariado determino los siguientes adversos factores: edad, mayores de 50 años, (OR 5.4, intervalo de confianza de 95 % (CI) 1.5–19.6); la exposición a múltiples inyecciones parenterales antes del año 2000 (OR 3.4, 95 % CI 1.5–7.6); intervenciones quirúrgicas (OR 2.6, 95 %CI 1.2–5.7) y fibroscopias (OR 2.4, 95 % CI 1.0–5.7). Esos resultados muestran la necesidad de una detección sistemática de HCV en PLWA y de reforzar la conciencia pública de la población y de los políticos sobre los riesgos asociados con inyecciones, fibroscopia and cirugía, y de desarrollar el tratamiendo de residuos medicales en la sanidad pública y privada de Camboya.

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Acknowledgments

The authors wish to thank all the patients who accepted to participate in this study; the doctors, nurses and technicians of Calmette Hospital and Institut Pasteur in Cambodia; ANRS, Alternat’ HIV and Institut Pasteur in Cambodia for supporting this study; Amada Bolgut who translated the abstract into Spanish language; Andrew Lover, Laurent Ferradini and Arnaud Tarantola who kindly reviewed the first drafts of manuscript; and ESTHER program for their continued support and funding.

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Authors and Affiliations

  1. Epidemiology and Public Health Unit, Pasteur Institute in Cambodia, 5, Boulevard Monivong, BP 983, Phnom Penh, Cambodia

    Sophie Goyet, Nathalie Lerolle, Isabelle Fournier-Nicolle & Ly Sowath

  2. Assistance Publique, Hôpitaux de Paris (AP-HP), Département de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Bicêtre, 78 rue du Général Leclerc, 94 276, Le Kremlin-Bicêtre, France

    Nathalie Lerolle, Jean-François Delfraissy & Olivier Segeral

  3. Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS), Paris, France

    Isabelle Fournier-Nicolle, Hubert Barennes & Jean-François Delfraissy

  4. Laboratory of HIV/Hepatitis, Institut Pasteur in Cambodia, Phnom Penh, Cambodia

    Sreymom Ken & Janin Nouhin

  5. Division of Infectious Diseases, Department of Internal Medicine, Calmette Hospital, Phnom Penh, Cambodia

    Chanroeurn Hak, Chakravuth Ung & Pichit Khuon

  6. Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Paris, France

    Chanroeurn Hak, Chakravuth Ung, Gérald Viretto, Jean-François Delfraissy, Pichit Khuon & Olivier Segeral

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  1. Sophie Goyet
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Correspondence to Sophie Goyet.

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Goyet, S., Lerolle, N., Fournier-Nicolle, I. et al. Risk Factors for Hepatitis C Transmission in HIV Patients, Hepacam Study, ANRS 12267 Cambodia. AIDS Behav 18, 495–504 (2014). https://doi.org/10.1007/s10461-013-0486-0

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