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

Ajay R. Bharti, Scott L. Letendre, Tanya Wolfson, David Clifford, Ann C. Collier, Benjamin Gelman, Justin McArthur, Christina Marra, Allen McCutchan, Susan Morgello, David Simpson, Ron J. Ellis, Igor Grant

Research output: Contribution to journalArticle

8 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)328-332
Number of pages5
JournalJournal of Clinical Virology
Volume52
Issue number4
DOIs
StatePublished - Dec 2011

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Virus Diseases
Coinfection
Hepacivirus
HIV
Logistic Models
RNA
Hepatitis C Antibodies
Viremia
ROC Curve
Blood Platelets
Regression Analysis
protein-bound SN-C polysaccharide

Keywords

  • Case finding
  • Co-infection
  • HIV
  • Seronegative HCV

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Bharti, A. R., Letendre, S. L., Wolfson, T., Clifford, D., Collier, A. C., Gelman, B., ... Grant, I. (2011). Clinical variables identify seronegative HCV co-infection in HIV-infected individuals. Journal of Clinical Virology, 52(4), 328-332. https://doi.org/10.1016/j.jcv.2011.08.021

Clinical variables identify seronegative HCV co-infection in HIV-infected individuals. / Bharti, Ajay R.; Letendre, Scott L.; Wolfson, Tanya; Clifford, David; Collier, Ann C.; Gelman, Benjamin; McArthur, Justin; Marra, Christina; McCutchan, Allen; Morgello, Susan; Simpson, David; Ellis, Ron J.; Grant, Igor.

In: Journal of Clinical Virology, Vol. 52, No. 4, 12.2011, p. 328-332.

Research output: Contribution to journalArticle

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 2011, 'Clinical variables identify seronegative HCV co-infection in HIV-infected individuals', Journal of Clinical Virology, vol. 52, no. 4, pp. 328-332. https://doi.org/10.1016/j.jcv.2011.08.021
Bharti AR, Letendre SL, Wolfson T, Clifford D, Collier AC, Gelman B et al. Clinical variables identify seronegative HCV co-infection in HIV-infected individuals. Journal of Clinical Virology. 2011 Dec;52(4):328-332. https://doi.org/10.1016/j.jcv.2011.08.021
Bharti, Ajay R. ; Letendre, Scott L. ; Wolfson, Tanya ; Clifford, David ; Collier, Ann C. ; Gelman, Benjamin ; McArthur, Justin ; Marra, Christina ; McCutchan, Allen ; Morgello, Susan ; Simpson, David ; Ellis, Ron J. ; Grant, Igor. / Clinical variables identify seronegative HCV co-infection in HIV-infected individuals. In: Journal of Clinical Virology. 2011 ; Vol. 52, No. 4. pp. 328-332.
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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.",
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