Hepatitis C Screening in People with Human Immunodeficiency Virus: Lessons Learned from Syphilis Screening

Background.  

The incidence of hepatitis C virus (HCV) infection is increasing in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). New guidelines recommend annual screening for HCV, similar to recommendations for syphilis screening with rapid plasma reagin (RPR). 

Methods. 

This study compares the frequency of repeat HCV antibody (Ab) testing to repeat RPR testing in a retrospective chart review of 359 HCVAb-negative people living with HIV (PLWH) observed in an Infectious Diseases clinic. Patients were classified into risk groups based on sexual risk factors. 

Results.

Although 85% of PLWH had repeat syphilis screening, less than two thirds had repeat HCVAb screening. The MSM status was associated with increased HCVAb and RPR testing (adjusted odds ratio, 2.6 and 5.9, respectively). Seven persons had incident HCV infection: 3 were MSM, and 4 had symptoms or abnormal laboratory results to prompt testing. 

Conclusions.

Failure to find incident HCV infection in PLWH represents missed opportunities to cure HCV infection and prevent progressive liver disease. Further quality improvement studies are necessary to develop physician-focused interventions to increase HCV screening rates in PLWH.

Full article at:   https://goo.gl/hCydqw

By:  Wurcel AG1, Chen DD2, Fitzpatrick RE2, Grasberger PE2, Kirshner CH2, Anderson JE2, Chui KK2, Knox TA2.

• 1Department of Geographic Medicine and Infectious Diseases, Tufts Medical Center; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
• 2Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts. 
• Open Forum Infect Dis. 2016 Feb 12;3(1):ofv215. doi: 10.1093/ofid/ofv215. eCollection 2016.

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