TY - JOUR
T1 - Factors associated with seronegative chronic hepatitis C virus infection in HIV infection
AU - Chamie, Gabriel
AU - Bonacini, Maurizio
AU - Bangsberg, David R.
AU - Stapleton, Jack T.
AU - Hall, Christopher
AU - Overton, E. Turner
AU - Scherzer, Rebecca
AU - Tien, Phyllis C.
N1 - Funding Information:
We would like to thank the FRAM study investigators. Financial support. The FRAM study was supported by the National Institutes of Health (NIH; RO1-DK57508, HL74814, HL 53359, and AI 027767) and the NIH General Clinical Research Center (M01-RR00036, RR00051, RR00052, RR00054, RR00083, RR0636, and RR00865). P.C.T. was supported by the National Institute of Allergy and Infectious Diseases (K23 AI 66943-01). The REACH Cohort was supported by the NIH (MH54907). D.R.B. received support from the National Institute on Alcohol Abuse and Alcoholism (AA015287).
PY - 2007/2/15
Y1 - 2007/2/15
N2 - Background. Chronic seronegative hepatitis C virus (HCV) infection is defined as being HCV antibody (anti-HCV) negative, but HCV RNA positivity occurs in individuals infected with human immunodeficiency virus (HIV). However, associated factors are not well established because of the small number of reported cases. Methods. Multivariate logistic regression analysis of HIV-infected subjects from 4 cohorts (Tien et al., 2006; Bonacini et al., 2001; George et al., 2002; and Hall et al., 2004) determined factors associated with HCV RNA positivity in anti-HCV-negative subjects. HCV enzyme immunoassay 2.0 was used to determine anti-HCV status. Results. Among 1174 anti-HCV-negative, HIV-infected subjects, the prevalence of seronegative HCV infection was 3.2% (95% confidence interval [CI], 2.2%-4.3%). History of injection drug use (IDU; OR, 5.8; 95% CI, 2.7-12.8), higher alanine aminotransferase (ALT) level (OR, 2.0 per doubling; 95% CI, 1.3-3.2), and CD4 cell count <200 cells/μL (OR, 2.3; 95% CI, 1.1-4.8) were associated with HCV RNA positivity in anti-HCV-negative subjects. Among those with a history of IDU who had either a CD4 cell count <200 cells/μL or an ALT level greater than the upper limit of normal, the prevalence of seronegative HCV infection was 24% (95% CI, 13%-39%). Conclusions. Detectable HCV RNA in the context of a negative HCV enzyme immunoassay 2.0 result in HIV-infected patients is low, but higher than the reported prevalence in HIV-uninfected patients. Our findings suggest that HCV RNA testing should be performed in anti-HCV-negative, HIV-infected patients, especially those with a history of IDU and either a CD4 cell count <200 cells/μL or an abnormal ALT level.
AB - Background. Chronic seronegative hepatitis C virus (HCV) infection is defined as being HCV antibody (anti-HCV) negative, but HCV RNA positivity occurs in individuals infected with human immunodeficiency virus (HIV). However, associated factors are not well established because of the small number of reported cases. Methods. Multivariate logistic regression analysis of HIV-infected subjects from 4 cohorts (Tien et al., 2006; Bonacini et al., 2001; George et al., 2002; and Hall et al., 2004) determined factors associated with HCV RNA positivity in anti-HCV-negative subjects. HCV enzyme immunoassay 2.0 was used to determine anti-HCV status. Results. Among 1174 anti-HCV-negative, HIV-infected subjects, the prevalence of seronegative HCV infection was 3.2% (95% confidence interval [CI], 2.2%-4.3%). History of injection drug use (IDU; OR, 5.8; 95% CI, 2.7-12.8), higher alanine aminotransferase (ALT) level (OR, 2.0 per doubling; 95% CI, 1.3-3.2), and CD4 cell count <200 cells/μL (OR, 2.3; 95% CI, 1.1-4.8) were associated with HCV RNA positivity in anti-HCV-negative subjects. Among those with a history of IDU who had either a CD4 cell count <200 cells/μL or an ALT level greater than the upper limit of normal, the prevalence of seronegative HCV infection was 24% (95% CI, 13%-39%). Conclusions. Detectable HCV RNA in the context of a negative HCV enzyme immunoassay 2.0 result in HIV-infected patients is low, but higher than the reported prevalence in HIV-uninfected patients. Our findings suggest that HCV RNA testing should be performed in anti-HCV-negative, HIV-infected patients, especially those with a history of IDU and either a CD4 cell count <200 cells/μL or an abnormal ALT level.
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U2 - 10.1086/511038
DO - 10.1086/511038
M3 - Article
C2 - 17243063
AN - SCOPUS:33846928953
SN - 1058-4838
VL - 44
SP - 577
EP - 583
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 4
ER -