Stable low hepatitis C virus antibody prevalence among HIV-negative MSM attending the STI outpatient clinic in Amsterdam, 2007 - 2017.

BACKGROUND: In response to the increased hepatitis C virus (HCV) prevalence recently found among participants of the Amsterdam pre-exposure prophylaxis demonstration project, we evaluated HCV prevalence over time and the performance of the HCV-MOSAIC risk score for detection of HCV infection in HIV-negative men who have sex with men (MSM) attending the Amsterdam STI clinic.

METHODS: In October 2016, HIV-negative MSM were tested for anti-HCV and HCV RNA and completed the HCV-MOSAIC risk score. Anti-HCV prevalence was compared to that found in cross-sectional studies at the Amsterdam STI clinic (2007-2017). The time trend in HCV prevalence was modeled via logistic regression. The performance of the HCV-MOSAIC risk score, adjusted to identify prevalent HCV infection, was evaluated by calculating sensitivity and specificity.

RESULTS: Of 504 HIV-negative MSM tested in October 2016, 5 were anti-HCV-positive (1.0%, 95%CI 0.4-2.3%) and all were HCV RNA-negative. Sensitivity and specificity of the adjusted HCV-MOSAIC risk score for prevalent infection were 80.0% (95%CI 37.6-96.4%) and 56.1% (95%CI 51.7-60.4%), respectively. The overall anti-HCV prevalence among 3264 HIV-negative MSM participating in cross-sectional studies at the Amsterdam STI clinic (2007-2017) was 0.8% (95%CI 0.5-1.2%) and did not change over time (p=0.55).

CONCLUSIONS: Anti-HCV prevalence among HIV-negative MSM attending the Amsterdam STI clinic in October 2016 was 1.0% and remained stable over time. We would therefore not recommend routine HCV screening of HIV-negative MSM at the STI clinic. However, given the increased prevalence among MSM using pre-exposure prophylaxis, periodic monitoring of HCV prevalence remains important.