HIV, HCV and HIV-HCV Coinfections in the General Population versus Inmates from Romania

Abstract

The objective of this study was to analyze the epidemiological links of the human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV-HCV coinfections to less studied types of transmission in certain populations. We performed an observational, prospective study on 903 patients aged between 15-87 years who took part in the Open Test Project. They were divided in two subgroups: general population vs. individuals from prisons who were questioned about multiple risk factors. A chi-square independence test was used to establish correlations between risk factors and results of screening tests. Logistic regression was used to calculate the probability of a reactive screening test based on each independent risk factor and age. HIV was very strongly associated with unprotected sexual intercourse with HIV-positive partners (the strongest association), unprotected sexual intercourse with sex workers, newly diagnosed sexually transmitted diseases (STDs), intravenous drug users (IDUs) and sharing injecting materials. In the case of HCV reactive tests, very strong associations have been established with IDUs (the strongest association), unprotected sex with IDUs and sharing injecting materials. Our study indicates the need for implementing targeted public health programs, tailored to the local epidemiology that can ultimately lead to micro-elimination of hepatitis and HIV infections in this area.

Keywords: HCV; HIV; HIV-HCV coinfection; IDUs; STDs; inmates; micro-elimination; strong association.

Figure 1

Variation in the probability of obtaining positive HIV and HCV screening tests or the presence of HIV-HCV coinfection based on the presence of the risk factor (intravenous drug users) among individuals in the general population and in the inmate population: (a) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the general population; (b) HCV in the general population; (c) HIV-HCV coinfection in the general population; (d) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the inmate population; (e) HCV in the inmate population; (f) HIV-HCV coinfection in the inmate population.

Figure 2

Variation in the probability of obtaining positive HIV and HCV screening tests or the presence of HIV-HCV coinfection based on the presence of the risk factor (sharing injection materials such as syringes and needles within the last 12 months) among individuals in the general population and in the inmate population: (a) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the general population; (b) HCV in the general population; (c) HIV-HCV coinfection in the general population; (d) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the inmate population; (e) HCV in the inmate population; (f) HIV-HCV coinfection in the inmate population.

Figure 3

Variation in the probability of obtaining positive HIV and HCV screening tests or the presence of HIV-HCV coinfection based on the presence of the risk factor (unprotected sexual intercourse with intravenous drug users in the past 12 months) among individuals in the general population and in the inmate population: (a) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the general population; (b) HCV in the general population; (c) HIV-HCV coinfection in the general population; (d) graphical representation of how the probability of a positive HIV screening test varies based on the presence or absence of the risk factor among individuals of the same age in the inmate population; (e) HCV in the inmate population; (f) HIV-HCV coinfection in the inmate population.

Figure 4

Established associations between risk factors and the results of the screening tests for HIV, HCV and coinfection in the general population and inmate population based on the phi coefficient and Cramer’s V coefficient.