1499. Differences in Demographic, Behavioral and Clinical Characteristics between HCV Mono-infected and HIV Co-infected Adults in Outpatient Primary Care
Session: Poster Abstract Session: HIV and Co-infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA_PDF_HCV_HIV_4by8_Final.pdf (288.1 kB)
  • Background: Of 3.2 million persons with Hepatitis C virus (HCV) infection in the U.S., 10%-15% are HIV-infected. With successful care and treatment HCV infection can be eradicated. Currently, the receipt of HCV RNA test, which confirms chronic infection, following a positive HCV antibody test (anti-HCV+) is a quality indicator for HCV care.  We examined differences in patient characteristics between HCV mono- and HCV/HIV co-infected persons to determine whether co-infection was a predictor of HCV RNA testing.

    Methods: We analyzed electronic medical record data of anti-HCV+ patients drawn from a multi-site retrospective study of patients aged ≥18 years, who utilized ≥1 primary care outpatient service between 2005 and 2010.  Anti-HCV+ patients with ICD-9 diagnosis code for HIV (V08, 042) were defined as co-infected.  We fit a multivariate logistic regression model to obtain adjusted odds ratios (aOR) for the association between patient characteristics (birth year, sex, race/ethnicity, marital status, injection drug use [IDU], alanine aminotransferase levels) and anti-HCV/HIV co-infection.  In a second model, we examined the relationship between anti-HCV/HIV co-infection and HCV RNA testing, adjusting for the same covariates.

    Results: Among 17,464 patients tested, 1,115 (6.4%) were anti-HCV+.  Of these, 133 (11.9%) were HIV co-infected.  After multivariate adjustment, we identified birth after 1965 (aOR, 95% CI: 2.0, 1.2- 3.3); male gender (1.8, 1.1- 2.8); never being married (4.3, 2.2- 8.5); Hispanic/Asian/other race/ethnicity (2.4, 1.3- 4.3); and IDU (2.7, 1.8- 4.0) were independently associated with anti-HCV/HIV co-infection.  About 66.6% (654/980) and 77.4% (103/133) of anti-HCV mono- and anti-HCV/HIV co-infected patients, respectively, received HCV RNA testing. The odds of receiving HCV RNA testing were higher among anti-HCV/HCV co-infected (1.9, 1.2- 3.0), relative to anti-HCV mono-infected patients.

    Conclusion: Our findings suggest significant differences between anti-HCV mono- and anti-HCV/HIV co-infected patients with respect to patient characteristics and the likelihood of receiving HCV RNA testing.  While anti-HCV/HIV co-infected were more likely than HCV mono-infected persons to receive HCV RNA testing, substantial proportions of both groups did not receive testing to confirm HCV infection, the identification of which is imperative for appropriate care and treatment.

    Anthony K. Yartel, MPH1, Rebecca L. Morgan, MPH2, David B. Rein, PhD3, Kimberly A. Brown, MD4, Natalie Kil, MPH5, Omar I. Massoud, MD6 and Bryce D. Smith, PhD2, (1)CDC Foundation, Atlanta, GA, (2)Division of Viral Hepatitis, CDC, Atlanta, GA, (3)NORC At the Univ. of Chicago, Atlanta, GA, (4)Henry Ford Hosp., Detroit, MI, (5)Mount Sinai Sch. of Medicine, New York, NY, (6)Univ. of Alabama At Birmingham, Birmingham, AL

    Disclosures:

    A. K. Yartel, None

    R. L. Morgan, None

    D. B. Rein, None

    K. A. Brown, None

    N. Kil, None

    O. I. Massoud, None

    B. D. Smith, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.