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 language | English (US) |
|---|---|
| Pages (from-to) | 328-332 |
| Number of pages | 5 |
| Journal | Journal of Clinical Virology |
| Volume | 52 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 2011 |
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Keywords
- Case finding
- Co-infection
- HIV
- Seronegative HCV
ASJC Scopus subject areas
- Virology
- Infectious Diseases
Cite this
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 journal › Article
}
TY - JOUR
T1 - Clinical variables identify seronegative HCV co-infection in HIV-infected individuals
AU - Bharti, Ajay R.
AU - Letendre, Scott L.
AU - Wolfson, Tanya
AU - Clifford, David
AU - Collier, Ann C.
AU - Gelman, Benjamin
AU - McArthur, Justin
AU - Marra, Christina
AU - McCutchan, Allen
AU - Morgello, Susan
AU - Simpson, David
AU - Ellis, Ron J.
AU - Grant, Igor
PY - 2011/12
Y1 - 2011/12
N2 - 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.
AB - 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.
KW - Case finding
KW - Co-infection
KW - HIV
KW - Seronegative HCV
UR - http://www.scopus.com/inward/record.url?scp=82755160756&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82755160756&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2011.08.021
DO - 10.1016/j.jcv.2011.08.021
M3 - Article
VL - 52
SP - 328
EP - 332
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
SN - 1386-6532
IS - 4
ER -