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Hepatitis C virus (HCV) infections in the United States occurred mostly among those born between 1945 and 1965. However, new infections continue to increase in recent years. To understand the changes in the prevalence and risk factors of HCV infection in different age and risk groups among men living with HIV, we performed a retrospective cross‐sectional analyses of 1948 HIV‐infected men at a multisite community health centre in urban/suburban and rural Maryland from 2003 through 2014. We used multivariate logistic regression to determine factors associated with HCV antibody (anti‐HCV) positivity and restricted cubic spline method to model trends in anti‐HCV prevalence over time. The overall anti‐HCV prevalence was 24.2%. The annual prevalence declined in the full cohort, from 38% in 2003 to 24% in 2014, and among those ≥ 40 years old. However, the annual prevalence increased initially and then stabilized in the groups of men who were younger (<40 years old) or had injection‐drug use and/or sex with men. Among the younger injection‐drug users, the prevalence rose from 33% in 2003 to 79% in 2009 and then stabilized. The independent predictors for anti‐HCV positivity differed between the men with and without injection‐drug use and between those < 40 and ≥ 40 years old. Notably, a high prevalence of anti‐HCV was observed among the younger, white injection‐drug users residing in rural areas. Thus, the HCV epidemic continued unabated among high‐risk individuals in this diverse population of HIV‐infected men. The ongoing HCV transmission among young HIV‐infected men poses a challenge en route to HCV eradication. [ABSTRACT FROM AUTHOR]

Objectives: Screening HIV-infected men for gonorrhoea (GC) and chlamydia (CT) may decrease HIV transmission and reduce the incidence of pelvic inflammatory disease in female partners. This study determined GC/CT testing rates in a clinical HIV cohort before and after 2003 when the US Centers for Disease Control and Prevention issued guidelines for GC/CT screening.Methods: First GC/CT testing episodes were identified for all men enrolling in a Baltimore HIV clinic from 1999 to 2007. Multivariate Cox and logistic regression were used to assess clinical and demographic factors associated with being tested and with having a positive result.Results: Among 1110 men, the rate of GC/CT testing upon clinic enrollment increased from 4.0% prior to 2003 to 16.5% afterwards, and the rate of ever being tested increased from 34.2% to 49.1% (p<0.001 for both comparisons). Among men with same sex contact, 10% of first testing episodes included extragenital sites. Among the 342 men ever-tested, 5.2% had positive results on first testing. Predictors of testing included enrolling after 2003, younger age, frequent visits and black race. Predictors of a positive test result included CD4 count ≥ 200 cells/mm(3) and younger age.Conclusions: GC/CT testing rates among men increased substantially after the 2003 guidelines but remain low. Disseminating existing evidence for GC/CT screening and promoting operational interventions to facilitate it are warranted. [ABSTRACT FROM AUTHOR]

Examines the persistence of class II human leukocytes antigen (HLA) in alleles and hepatitis B virus (HBV) in Afro-Americans in Baltimore, Maryland. Factor contributing to the persistence of HBV infection; Effect of allelic differences in HLA complex on HBV persistence; Association of HBV persistence with class II allelic homozygosity.

Objectives: Little is known about the cascade of hepatitis C care among HIV/hepatitis C virus (HCV)-coinfected patients in community-based clinics. Thus, we analysed our data from the interferon era to understand the barriers to HCV treatment, which may help improve getting patients into treatment in the direct-acting antivirals era., Design: Retrospective cohort study., Setting: Four HIV clinics of a multisite community health centre in the USA., Participants: 1935 HIV-infected men with >1 medical visit to the clinic between 2011 and 2013. Of them, 371 had chronic HCV and were included in the analysis for HCV care continuum during 2003-2014., Outcome Measures: HCV treatment initiation was designated as the primary outcome for analysis. Multivariate logistic regression was performed to identify factors associated with HCV treatment initiation., Results: Among the 371 coinfected men, 57 (15%) initiated HCV treatment. Entering care before 2008 (adjusted OR [aOR, 3.89; 95% CI, 1.95 to 7.78), higher educational attainment (aOR, 3.20; 95% CI, 1.59 to 6.44), HCV genotype 1 versus non-1 (aOR, 0.21; 95% CI, 0.07 to 0.65) and HIV suppression (aOR, 2.13; 95% CI, 1.12 to 4.06) independently predicted treatment initiation. Stratification by entering care before or after 2008 demonstrated that higher educational attainment was the only factor independently associated with treatment uptake in both periods (aOR, 2.79; 95% CI, 1.13 to 6.88 and aOR, 4.10; 95% CI, 1.34 to 12.50, pre- and post-2008, respectively). Additional associated factors in those entering before 2008 included HCV genotype 1 versus non-1 (aOR, 0.09; 95% CI, 0.01 to 0.54) and HIV suppression (aOR, 2.35; 95% CI, 1.04 to 5.33)., Conclusions: Some traditional barriers predicted HCV treatment initiation in those in care before 2008; however, the patients' level of educational attainment remained an important factor even towards the end of the interferon era. Further studies will need to determine whether educational attainment persists as an important determinant for initiating direct-acting antiviral therapies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)