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. 2021 Apr 17;8(4):ofaa645.
doi: 10.1093/ofid/ofaa645. eCollection 2021 Apr.

Hepatitis C Virus Testing Among Men With Human Immunodeficiency Virus Who Have Sex With Men: Temporal Trends and Racial/Ethnic Disparities

Jun Li  1 , Carl Armon  2 , Frank J Palella  3 , Ellen Tedaldi  4 , Richard M Novak  5 , Jack Fuhrer  6 , Gina Simoncini  4 , Kimberly Carlson  2 , Kate Buchacz  1 ; HIV Outpatient Study (HOPS) Investigators
Collaborators, Affiliations

Hepatitis C Virus Testing Among Men With Human Immunodeficiency Virus Who Have Sex With Men: Temporal Trends and Racial/Ethnic Disparities

Jun Li et al. Open Forum Infect Dis. .

Abstract

Background: National guidelines recommend that sexually active people with human immunodeficiency virus (PWH) who are men who have sex with men (MSM) be tested for hepatitis C virus (HCV) infection at least annually. Hepatitis C virus testing rates vary by race/ethnicity in the general population, but limited data are available for PWH.

Methods: We analyzed medical records data from MSM in the HIV Outpatient Study at 9 human immunodeficiency virus (HIV) clinics from January 1, 2011 through December 31, 2019. We excluded observation time after documented past or current HCV infection. We evaluated HCV antibody testing in each calendar year among HCV-seronegative MSM, and we assessed testing correlates by generalized estimating equation analyses.

Results: Of 1829 eligible MSM who were PWH, 1174 (64.2%) were non-Hispanic/Latino white (NHW), 402 (22.0%) non-Hispanic black (NHB), 187 (10.2%) Hispanic/Latino, and 66 (3.6%) of other race/ethnicity. Most were ≥40 years old (68.9%), privately insured (64.5%), with CD4 cell count/mm3 (CD4) ≥350 (77.0%), and with HIV viral load <200 copies/mL (76.9%). During 2011-2019, 1205 (65.9%) had ≥1 HCV antibody test and average annual HCV percentage tested was 30.3% (from 33.8% for NHB to 28.5% for NHW; P < .001). Multivariable factors positively associated (P < .05) with HCV testing included more recent HIV diagnosis, public insurance, lower CD4, prior chlamydia, gonorrhea, syphilis, or hepatitis B virus diagnoses, and elevated liver enzyme levels, but not race/ethnicity.

Conclusions: Although we found no disparities by race/ethnicity in HCV testing, low overall HCV testing rates indicate suboptimal uptake of recommended HCV testing among MSM in HIV care.

Keywords: HCV testing; HIV/AIDS; epidemiology; hepatitis; treatment-naive.

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Figures

Figure 1.
Figure 1.
Participant selection flow chart. Abbreviations: HCV, hepatitis C virus; HIV, human immunodeficiency virus; HOPS, HIV Outpatient Study; MSM, who are men who have sex with men.
Figure 2.
Figure 2.
Percentage of hepatitis C virus antibody testing among men with HIV who have sex with men by race/ethnicity and calendar year, the HIV Outpatient Study, 2011–2019, N = 1829. Note: Each graph has a fitted regression line, respective P value for difference between estimated slope and zero slope, and 95% confidence intervals for each data point.
See this image and copyright information in PMC

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