HIV Infection Status as a Predictor of Hepatitis C Virus RNA Testing in Primary Care

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Yartel, Anthony K. ; Morgan, Rebecca L. ; Rein, David B. ; Brown, Kimberly Ann ; Kil, Natalie B. ; Massoud, Omar I. ; Fallon, Michael B. ; Smith, Bryce D.
• Description:
  Introduction
  
  Receipt of hepatitis C virus (HCV) RNA testing following a positive HCV antibody (anti-HCV+) test result to establish current infection is a quality indicator for HCV-related care. This study examines HIV infection status as a predictor of HCV RNA test receipt after an anti-HCV+ result in the primary care setting.
  
  Methods
  
  Electronic medical records of anti-HCV+ patients from a multisite retrospective study of patients aged ≥18 years who utilized one or more primary care outpatient services during 2005–2010 were analyzed in 2014. A multivariable logistic regression model examined the independent relationships between patient characteristics and receipt of HCV RNA testing.
  
  Results
  
  Among 1,115 anti-HCV+ patients, 133 (11.9%) were also HIV-positive. Of these, 77.4% (n=103) underwent HCV RNA testing to determine current infection status. By contrast, 66.7% (n=654/980) of anti-HCV+ patients who were HIV-negative received HCV RNA testing. Following multivariable adjustment, the odds of receiving HCV RNA testing were higher among anti-HCV+ patients who were also HIV-positive (AOR=1.9, 95% CI=1.2, 3.0), compared with their HIV-negative counterparts. Elevated alanine aminotransferase level was also associated with receipt of HCV RNA testing (AOR=1.9, 95% CI=1.4, 2.4). Black race was associated with decreased odds of receiving HCV RNA testing (AOR=0.7, 95% CI=0.5, 1.0).
  
  Conclusions
  
  HIV infection status is independently associated with the likelihood of receiving HCV RNA testing following an anti-HCV+ result. One quarter of anti-HCV+ patients who were also HIV-positive and one third of their HIV-negative counterparts, respectively, did not receive testing to establish active HCV infection, which is imperative for appropriate care and treatment.
  
  
• Subjects:
  Female Hepatitis C Hepatitis C Antibodies HIV Infections Humans Logistic Models Male Middle Aged Primary Health Care Quality Indicators, Health Care Quality Of Health Care Retrospective Studies RNA, Viral

  More +
• Source:
  Am J Prev Med. 49(3):423-427
• Pubmed ID:
  25896194
• Pubmed Central ID:
  PMC4556132
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  49
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:189758a6384d0f7af0af4ae32c8fb740323e1305b86e4f5c2f4aeec7e16e2757
• Download URL:
  https://stacks.cdc.gov/view/cdc/34009/cdc_34009_DS1.pdf
• File Type:
  [PDF - 121.37 KB ]