Hepatitis C virus testing in adults living with HIV: A need for improved screening efforts

Baligh R. Yehia, Ramin S. Herati, John A. Fleishman, Joel E. Gallant, Allison L. Agwu, Stephen A. Berry, Philip (Todd) Korthuis, Richard D. Moore, Joshua P. Metlay, Kelly A. Gebo

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Guidelines recommend hepatitis C virus (HCV) screening for all people living with HIV (PLWH). Understanding HCV testing practices may improve compliance with guidelines and can help identify areas for future intervention. Methods: We evaluated HCV screening and unnecessary repeat HCV testing in 8,590 PLWH initiating care at 12 U.S. HIV clinics between 2006 and 2010, with follow-up through 2011. Multivariable logistic regression examined the association between patient factors and the outcomes: HCV screening (≥1 HCV antibody tests during the study period) and unnecessary repeat HCV testing (≥1 HCV antibody tests in patients with a prior positive test result). Results: Overall, 82% of patients were screened for HCV, 18% of those screened were HCV antibody-positive, and 40% of HCV antibody-positive patients had unnecessary repeat HCV testing. The likelihood of being screened for HCV increased as the number of outpatient visits rose (adjusted odds ratio 1.02, 95% confidence interval 1.01-1.03). Compared to men who have sex with men (MSM), patients with injection drug use (IDU) were less likely to be screened for HCV (0.63, 0.52-0.78); while individuals with Medicaid were more likely to be screened than those with private insurance (1.30, 1.04-1.62). Patients with heterosexual (1.78, 1.20-2.65) and IDU (1.58, 1.06-2.34) risk compared to MSM, and those with higher numbers of outpatient (1.03, 1.01-1.04) and inpatient (1.09, 1.01-1.19) visits were at greatest risk of unnecessary HCV testing. Conclusions: Additional efforts to improve compliance with HCV testing guidelines are needed. Leveraging health information technology may increase HCV screening and reduce unnecessary testing.

Original languageEnglish (US)
Article numbere102766
JournalPLoS One
Volume9
Issue number7
DOIs
StatePublished - Jul 17 2014

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Hepatitis C virus
Viruses
Hepacivirus
Screening
HIV
screening
Testing
Hepatitis C Antibodies
testing
Guidelines
drug injection
antibodies
Outpatients
compliance
Medical Informatics
Injections
Heterosexuality
Medicaid
Insurance
health information

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Yehia, B. R., Herati, R. S., Fleishman, J. A., Gallant, J. E., Agwu, A. L., Berry, S. A., ... Gebo, K. A. (2014). Hepatitis C virus testing in adults living with HIV: A need for improved screening efforts. PLoS One, 9(7), [e102766]. https://doi.org/10.1371/journal.pone.0102766

Hepatitis C virus testing in adults living with HIV : A need for improved screening efforts. / Yehia, Baligh R.; Herati, Ramin S.; Fleishman, John A.; Gallant, Joel E.; Agwu, Allison L.; Berry, Stephen A.; Korthuis, Philip (Todd); Moore, Richard D.; Metlay, Joshua P.; Gebo, Kelly A.

In: PLoS One, Vol. 9, No. 7, e102766, 17.07.2014.

Research output: Contribution to journalArticle

Yehia, BR, Herati, RS, Fleishman, JA, Gallant, JE, Agwu, AL, Berry, SA, Korthuis, PT, Moore, RD, Metlay, JP & Gebo, KA 2014, 'Hepatitis C virus testing in adults living with HIV: A need for improved screening efforts', PLoS One, vol. 9, no. 7, e102766. https://doi.org/10.1371/journal.pone.0102766
Yehia BR, Herati RS, Fleishman JA, Gallant JE, Agwu AL, Berry SA et al. Hepatitis C virus testing in adults living with HIV: A need for improved screening efforts. PLoS One. 2014 Jul 17;9(7). e102766. https://doi.org/10.1371/journal.pone.0102766
Yehia, Baligh R. ; Herati, Ramin S. ; Fleishman, John A. ; Gallant, Joel E. ; Agwu, Allison L. ; Berry, Stephen A. ; Korthuis, Philip (Todd) ; Moore, Richard D. ; Metlay, Joshua P. ; Gebo, Kelly A. / Hepatitis C virus testing in adults living with HIV : A need for improved screening efforts. In: PLoS One. 2014 ; Vol. 9, No. 7.
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abstract = "Objectives: Guidelines recommend hepatitis C virus (HCV) screening for all people living with HIV (PLWH). Understanding HCV testing practices may improve compliance with guidelines and can help identify areas for future intervention. Methods: We evaluated HCV screening and unnecessary repeat HCV testing in 8,590 PLWH initiating care at 12 U.S. HIV clinics between 2006 and 2010, with follow-up through 2011. Multivariable logistic regression examined the association between patient factors and the outcomes: HCV screening (≥1 HCV antibody tests during the study period) and unnecessary repeat HCV testing (≥1 HCV antibody tests in patients with a prior positive test result). Results: Overall, 82{\%} of patients were screened for HCV, 18{\%} of those screened were HCV antibody-positive, and 40{\%} of HCV antibody-positive patients had unnecessary repeat HCV testing. The likelihood of being screened for HCV increased as the number of outpatient visits rose (adjusted odds ratio 1.02, 95{\%} confidence interval 1.01-1.03). Compared to men who have sex with men (MSM), patients with injection drug use (IDU) were less likely to be screened for HCV (0.63, 0.52-0.78); while individuals with Medicaid were more likely to be screened than those with private insurance (1.30, 1.04-1.62). Patients with heterosexual (1.78, 1.20-2.65) and IDU (1.58, 1.06-2.34) risk compared to MSM, and those with higher numbers of outpatient (1.03, 1.01-1.04) and inpatient (1.09, 1.01-1.19) visits were at greatest risk of unnecessary HCV testing. Conclusions: Additional efforts to improve compliance with HCV testing guidelines are needed. Leveraging health information technology may increase HCV screening and reduce unnecessary testing.",
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N2 - Objectives: Guidelines recommend hepatitis C virus (HCV) screening for all people living with HIV (PLWH). Understanding HCV testing practices may improve compliance with guidelines and can help identify areas for future intervention. Methods: We evaluated HCV screening and unnecessary repeat HCV testing in 8,590 PLWH initiating care at 12 U.S. HIV clinics between 2006 and 2010, with follow-up through 2011. Multivariable logistic regression examined the association between patient factors and the outcomes: HCV screening (≥1 HCV antibody tests during the study period) and unnecessary repeat HCV testing (≥1 HCV antibody tests in patients with a prior positive test result). Results: Overall, 82% of patients were screened for HCV, 18% of those screened were HCV antibody-positive, and 40% of HCV antibody-positive patients had unnecessary repeat HCV testing. The likelihood of being screened for HCV increased as the number of outpatient visits rose (adjusted odds ratio 1.02, 95% confidence interval 1.01-1.03). Compared to men who have sex with men (MSM), patients with injection drug use (IDU) were less likely to be screened for HCV (0.63, 0.52-0.78); while individuals with Medicaid were more likely to be screened than those with private insurance (1.30, 1.04-1.62). Patients with heterosexual (1.78, 1.20-2.65) and IDU (1.58, 1.06-2.34) risk compared to MSM, and those with higher numbers of outpatient (1.03, 1.01-1.04) and inpatient (1.09, 1.01-1.19) visits were at greatest risk of unnecessary HCV testing. Conclusions: Additional efforts to improve compliance with HCV testing guidelines are needed. Leveraging health information technology may increase HCV screening and reduce unnecessary testing.

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