HIV-infected men who have sex with men who identify themselves as belonging to subcultures are at increased risk for hepatitis C infection

PLoS One. 2013;8(3):e57740. doi: 10.1371/journal.pone.0057740. Epub 2013 Mar 4.


Background: Hepatitis C virus (HCV) emerged as sexually transmitted infection among HIV-infected men who have sex with men (MSM). We studied whether HCV circulated in identifiable high-risk MSM subcultures and performed phylogenetic analysis.

Methods: HIV-infected MSM were recruited at the sexually transmitted infections (STI) outpatient clinic and a university HIV clinic in Amsterdam, the Netherlands, 2008-2009. Participants completed a detailed questionnaire and were tested for HCV antibodies and RNA, with NS5B regions sequenced for analysis of clusters.

Results: Among 786 participants, the median age was 43 (IQR 37-48) years, and 93 (11.8%) were HCV-positive. Seropositivity was associated with belonging to subcultures identified as leather (aOR 2.60; 95% CI 1.56-4.33), rubber/lycra (aOR 2.15; 95% CI 1.10-4.21), or jeans (aOR 2.23; 95% CI 1.41-3.54). The two largest HCV-RNA monophyletic clusters were compared; MSM in cluster I (genotype 1a, n = 13) reported more partners (P = 0.037) than MSM in cluster II (genotype 4d, n = 14), but demographics, subculture characteristics and other risk behaviors did not differ significantly between the two clusters.

Discussion: HCV infection is associated with identifiable groups of leather/rubber/lycra/jeans subcultures among HIV-infected MSM. Separate epidemiological HCV transmission networks were not revealed. Active HCV screening and treatment within specific subcultures may reduce HCV spread among all MSM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cultural Characteristics*
  • HIV Infections / blood*
  • HIV Infections / complications
  • HIV Infections / immunology
  • HIV*
  • Hepacivirus / immunology*
  • Hepatitis C / blood*
  • Hepatitis C / complications
  • Hepatitis C / immunology
  • Hepatitis C / transmission*
  • Hepatitis C Antibodies / blood*
  • Homosexuality, Male / psychology
  • Humans
  • Male
  • Risk Factors
  • Risk-Taking
  • Sexual Behavior / psychology


  • Hepatitis C Antibodies

Grant support

This study is funded by the Netherlands Organisation for Health Research (ZonMw) [grant number 125010008]. Joost Vanhommerig was supported by Public Health Service R&D grant 2011 and AIDS foundation HIV/AIDS [Grant number 2008026]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.