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

Anthony K. Yartel, Rebecca L. Morgan, David B. Rein, Kimberly Ann Brown, Natalie B. Kil, Omar I. Massoud, Michael B. Fallon, Bryce D. Smith

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article number4367
Pages (from-to)423-427
Number of pages5
JournalAmerican Journal of Preventive Medicine
Volume49
Issue number3
DOIs
StatePublished - Sep 1 2015

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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    Yartel, A. K., Morgan, R. L., Rein, D. B., Brown, K. A., Kil, N. B., Massoud, O. I., Fallon, M. B., & Smith, B. D. (2015). HIV Infection Status as a Predictor of Hepatitis C Virus RNA Testing in Primary Care. American Journal of Preventive Medicine, 49(3), 423-427. [4367]. https://doi.org/10.1016/j.amepre.2015.03.003