AI Article Synopsis
- The study examined the rates of new hepatitis C virus (HCV) infections among HIV-positive patients in the U.S. from 2000 to 2013 through the HIV Outpatient Study (HOPS), focusing on individuals with prior negative HCV antibody tests.
- A total of 1941 patients were analyzed, leading to a reported incidence of 5.3% for new HCV infections, with the rates declining over time, particularly among people who inject drugs (PWID) and heterosexuals, but not among men who have sex with men (MSM).
- The study highlights the need for annual HCV screenings for HIV patients, especially for those at risk, to facilitate early diagnosis and treatment of co-infections
Article Abstract
Background: There are few recent studies of incident hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected patients in the United States.
Methods: We studied HIV Outpatient Study (HOPS) participants seen in 9 HIV-specialty clinics who had ≥1 clinical encounter during 2000-2013 and ≥2 HCV-related tests, the first of which was a negative HCV antibody test (Ab). Hepatitis C virus incident cases were identified by first positive HCV Ab, viral load, or genotype. We assessed rates of incident HCV overall, by calendar intervals, and by demographic and HIV risk strata, and we explored risk factors for incident HCV using Cox proportional hazards models.
Results: The 1941 eligible patients (median age 40 years, 23% female, 61% men who had sex with men [MSM], and 3% persons who injected drugs [PWID]) experienced 102 (5.3%) incident HCV infections for an overall incidence of 1.07 (95% confidence interval [CI], 0.87-1.30) per 100 person-years (py). Hepatitis C virus incidence decreased from 1.83 in 2000-2003 to 0.88 in 2011-2013 ( = .024), with decreases observed ( < .05) among PWID and heterosexuals, but not among MSM. Overall, MSM comprised 59% of incident cases, and PWID were at most risk for incident HCV infection (adjusted hazard ratio [aHR] for PWID = 4.62 and 95% CI = 2.11-10.13; for MSM, aHR = 1.48 and 95% CI = 0.86-2.55 compared with heterosexuals).
Conclusions: Among HIV-infected patients in care during 2000-2013, incidence of HCV infection exceeded 1 case per 100 py. Our findings support recommendations for annual HCV screenings for HIV-infected persons, including persons with only MSM risk, to enable HCV diagnosis and treatment for coinfected individuals.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466816 | PMC |
| http://dx.doi.org/10.1093/ofid/ofx076 | DOI Listing |
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