Clinical variables identify seronegative HCV co-infection in HIV-infected individuals.

TitleClinical variables identify seronegative HCV co-infection in HIV-infected individuals.
Publication TypeJournal Article
Year of Publication2011
AuthorsBharti, 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
JournalJ Clin Virol
Volume52
Issue4
Pagination328-32
Date Published2011 Dec
ISSN1873-5967
KeywordsAdult, 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.

DOI10.1016/j.jcv.2011.08.021
Alternate JournalJ. Clin. Virol.
PubMed ID21924674
PubMed Central IDPMC3217127
Grant ListK23 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