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Men with HIV who initially test negative for HCV should be re-tested later
Taylor LE. Clin Infect Dis. 2011;doi:10.1093/cid/ciq201.
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Of 1,830 men with HIV who initially tested negative for the hepatitis C virus, 36 seroconverted, making the overall incidence of 0.51 cases per 100 person-years, according to data from the ALLRT study, published in Clinical Infectious Diseases.
As part of the AIDS Clinical Trial Group Longitudinal Linked Randomized Trials (ALLRT) study, men with HIV who were being treated with highly active antiretroviral therapy and who were part of an AIDS Clinical Trial Group (ACTG) study were examined for long-term immunologic, virologic, pharmacologic and clinical outcomes associated with HAART.
Researchers from Brown University measured the rate of incident hepatitis C virus (HCV) infection among men enrolled in the ALLRT study. This study included 1,830 men who had initially tested negative for HCV and who had at least one subsequent HCV antibody test.
At the time of the first negative HCV antibody test, 94% of the men were being treated with HAART, and 6% reported current or prior injection drug use.
The baseline prevalence of HCV was 10%. A total of 2,365 men initially tested negative for HCV, and of these, 1,830 had a subsequent HCV antibody test. Upon subsequent HCV antibody test, 36 of these men had seroconverted. The mean period between HCV antibody testing was 2.8 years in those who seroconverted and 2.6 years in those who did not. The mean age at time of seroconversion was 46 years.
Seroconversion was associated with injection drug use: 25% of the seroconverters reported a history of injection drug use vs. 5% of the non-seroconverters. Seroconversion was also associated with an HIV RNA level of more than 400 copies/mL: 44% of the seroconverters had an HIV RNA level of more than 400 copies/mL at the time of antibody positivity, whereas only 21% of non-seroconverters had an HIV RNA level of more than 400 copies/mL at the last negative antibody test.
“Screening HIV-infected patients for hepatitis C only once upon entry into HIV care is not sufficient,” study researcher Lynn E. Taylor, MD, assistant professor of medicine at Brown University, said in a news release. “The standard of care needs to change. HIV-infected persons should have access to ongoing screening for hepatitis C. Doctors and patients may not be aware of or freely discuss all risk behaviors that may lead to hepatitis C infection. These behaviors are often stigmatized. Patients may not feel comfortable discussing these risk factors nor may they be aware of all the ways in which hepatitis C may be transmitted via blood.”
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