Hepatitis C virus testing in a clinical HIV cohort in Ontario, Canada, 2000 to 2015. Issue 3 (18th September 2021)

• Record Type: Journal Article
• Authors: Moqueet, Nasheed; Grewal, Ramandip; Mazzulli, Tony; Cooper, Curtis; Gardner, Sandra L.; Salit, Irving E.; Kroch, Abigail; Burchell, Ann N.
• Other Names: Kroch Abigail investigator.; Burchell Ann investigator.; Rueda Sergio investigator.; Arbess Gordon investigator.; Cohen Jeffrey investigator.; Cooper Curtis investigator.; Lavoie Elizabeth investigator.; Crouzat Fred investigator.; Andany Nisha investigator.; Walmsley Sharon investigator.; Silverman Michael investigator.; Sandre Roger investigator.; Tharao Wangari investigator.; Gauvin Holly investigator.; Smaill Fiona investigator.; Martinez‐Cajas Jorge investigator.
• Is Part Of: Health science reports. Volume 4:Issue 3(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-09-18
• Subjects: Coinfection/epidemiology -- hepatitis C/epidemiology* -- hepatitis C virus testing -- HIV infections/epidemiology* -- HIV‐HCV co‐infection; 610
• DOI: 10.1002/hsr2.358
• Languages: English
• ISSNs: 2398-8835

Abstract

Abstract: Background: HIV‐positive individuals may acquire HCV via injection drug use (IDU) and condomless anal sex. HIV care provides opportunities for HCV testing and cure with direct‐acting antiviral agents (DAAs). Methods: We analyzed data from the Ontario HIV Treatment Network Cohort Study. Among those not HCV‐positive or diagnosed previously (n = 4586), we used Cox regression to test the rates of ever HCV testing (serological or RNA) in HIV care by DAA era (pre‐DAA: 2000‐2010; after DAA: 2011‐2015) and compared the proportion diagnosed with HCV. We identified correlates of annual proportions of serological testing using Poisson generalized estimating equations. Results: After DAA vs pre‐DAA, the hazard rate ratio (95% CI) of ever HCV testing was 1.70 (1.59, 1.81). The proportion (95% CI) tested annually increased from 9.2% (8.0%, 10.7%) in 2000 to 39.1% (37.1%, 41.1%) in 2015 ( P < 0.0001). The proportion diagnosed with HCV declined by 74% pre‐DAA to 11% after DAAs. Annual testing increased per calendar year (16% steeper slope after DAA vs pre‐DAA) and was more common among men who have sex with men; those more educated (post‐secondary vs ≤ high school); and those positive for syphilis or reporting any IDU. Annual testing decreased per decade of age and time since HIV diagnosis. Discussion: Annual HCV testing increased over time with higher testing among those reporting sexual or IDU risk factors, but fell short of clinical guidelines. Targeted interventions to boost testing may be needed to close these gaps and reach WHO 2030 HCV elimination targets.