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Hepatitis C Testing Is Lacking in High-Risk Patients with HIV

People with the human immunodeficiency virus (HIV) are at a higher risk of having hepatitis C (HCV), however, less than two-thirds of patients are being screened regularly.

People with the human immunodeficiency virus (HIV) are at a higher risk of having hepatitis C (HCV), however, less than two-thirds of patients are being screened regularly.

About 25% of patients with HIV are also infected with HCV, according to the Centers for Disease Control and Prevention (CDC). Despite this startling statistic, many patients with HIV are not tested for the coinfection on a regularly basis. Researchers from Tufts Medical Center and Tufts University School of Medicine in Boston found out just how prevalent hepatitis C testing is in this high-risk population.

“Failure to find incident HCV infection in people living with HIV represents missed opportunities to cure HCV infection and prevention of progressive liver disease,” the authors wrote in Open Forum Infectious Diseases.

A total of 359 patients with HIV were seen at an infectious disease clinic from April 1, 2010 to December 31, 2013. All of the participants had a negative HCV status at baseline and at least one year in between a minimum of two clinic visits. About half of the cohort were white men who have sex with men, and there was a very low percentage of patients who reported injected drug use.

It turns out that patients had less repeated testing for HCV than for syphilis (62.4% vs 84.4%, respectively). In addition, there was longer time between testing for HCV than syphilis. Patients with HIV are more susceptible to both HCV and syphilis; however, the findings reveal that only two-thirds receive HCV testing and over four-fifths get tested for syphilis on a repeated basis.

“We also found that one-third of the groups at highest risk for HCV infection, those with a history of syphilis and men who have sex with men, did not have evidence of repeat HCV antibody testing,” the researchers confirmed.

These results beg the question: why aren’t these high-risk patients being tested more often for a disease that they’re more likely to contract? The team hypothesizes that health care providers may not recognize changes in HCV epidemiology. They may also face systematic barriers that confront annual testing practices.

“Further quality improvement studies are necessary to develop physician-focused interventions to increase HCV screening rates in people living with HIV,” the authors concluded.