Clinical variables identify seronegative HCV co-infection in HIV-infected individuals.
Title | Clinical variables identify seronegative HCV co-infection in HIV-infected individuals. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Bharti, AR, Letendre, SL, Wolfson, T, Clifford, D, Collier, AC, Gelman, B, McArthur, J, Marra, C, McCutchan, A, Morgello, S, Simpson, D, Ellis, RJ, Grant, I |
Journal | J Clin Virol |
Volume | 52 |
Issue | 4 |
Pagination | 328-32 |
Date Published | 2011 Dec |
ISSN | 1873-5967 |
Keywords | Adult, African Continental Ancestry Group, Alanine Transaminase, Aspartate Aminotransferases, Biomarkers, CHARTER, Coinfection, Female, Hepatitis C, Hepatitis C Antibodies, HIV Infections, Humans, Internal, Male, Middle Aged, Risk Factors, RNA, Viral, Substance Abuse, Intravenous, Thrombocytopenia |
Abstract | BACKGROUND: A substantial number of people living with HIV (PLWH) are co-infected with Hepatitis C Virus (HCV) but have a negative screening HCV antibody test (seronegative HCV infection, or SN-HCV).OBJECTIVE: To identify a concise set of clinical variables that could be used to improve case finding for SN-HCV co-infection among PLWH.STUDY DESIGN: Two hundred HIV-infected participants of the CHARTER study were selected based on 7 clinical variables associated with HCV infection but were HCV seronegative. Data were analyzed using Fisher's exact tests, receiver-operating characteristic (ROC) curves, and logistic regression.RESULTS: Twenty-six (13%) participants had detectable HCV RNA. SN-HCV was associated with a history of IDU, elevated ALT and AST, low platelets, black ethnicity, and undetectable HIV RNA in plasma. Each of these clinical variables, except for abnormal AST, remained independently associated with SN-HCV in a multivariate logistic regression analysis. A composite risk score correctly identified SN-HCV with sensitivity up to 85% and specificity up to 88%.CONCLUSIONS: In a substantial minority of PLWH, seronegative HCV viremia can be predicted by a small number of clinical variables. These findings, after validation in an unselected cohort, could help focus screening in those at highest risk. |
DOI | 10.1016/j.jcv.2011.08.021 |
Alternate Journal | J. Clin. Virol. |
PubMed ID | 21924674 |
PubMed Central ID | PMC3217127 |
Grant List | K23 MH085512 / MH / NIMH NIH HHS / United States R25 MH81482 / MH / NIMH NIH HHS / United States R25 MH081482 / MH / NIMH NIH HHS / United States N01MH22005 / MH / NIMH NIH HHS / United States 1K23MH085512-01A2 / MH / NIMH NIH HHS / United States K23 MH085512-01A2 / MH / NIMH NIH HHS / United States N01 MH022005 / MH / NIMH NIH HHS / United States |