HCV co-infection in HIV positive population in British Columbia, Canada

• Published in: BMC public health Vol. 10; no. 1; p. 225
• Main Authors: Buxton, Jane A, Yu, Amanda, Kim, Paul H, Spinelli, John J, Kuo, Margot, Alvarez, Maria, Gilbert, Mark, Krajden, Mel
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.04.2010; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies; British Columbia - epidemiology; Comorbidity; Confidence intervals; Confidentiality; Datasets; Development and progression; Disease control; Disease prevention; Ethnicity; Female; Health aspects; Hepatitis C; Hepatitis C - complications; Hepatitis C - epidemiology; Hepatitis C - ethnology; HIV; HIV infection; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - ethnology; HIV Seropositivity - epidemiology; HIV Seropositivity - ethnology; HIV testing; Human immunodeficiency virus; Humans; Indians, North American; Infections; Liver cirrhosis; Male; Methods; Middle Aged; Personal health; Population; Population Surveillance; Prevalence; Prevalence studies (Epidemiology); Public health; Public health administration; Regression analysis; Research article; Risk factors; Seroepidemiologic Studies; Sexual Behavior; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - ethnology; Young Adult; British Columbia; Canada; British Columbia Canada; Vancouver British Columbia Canada
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-10-225

As HIV and hepatitis C (HCV) share some modes of transmission co-infection is not uncommon. This study used a population-based sample of HIV and HCV tested individuals to determine the prevalence of HIV/HCV co-infection, the sequence of virus diagnoses, and demographic and associated risk factors. Positive cases of HIV were linked to the combined laboratory database (of negative and positive HCV antibody results) and HCV reported cases in British Columbia (BC). Of 4,598 HIV cases with personal identifiers, 3,219 (70%) were linked to the combined HCV database, 1,700 (53%) of these were anti-HCV positive. HCV was diagnosed first in 52% of co-infected cases (median time to HIV identification 3 1/2 years). HIV and HCV was diagnosed within a two week window in 26% of cases. Among individuals who were diagnosed with HIV infection at baseline, subsequent diagnoses of HCV infection was independently associated with: i) intravenous drug use (IDU) in males and females, Hazard Ratio (HR) = 6.64 (95% CI: 4.86-9.07) and 9.76 (95% CI: 5.76-16.54) respectively; ii) reported Aboriginal ethnicity in females HR = 2.09 (95% CI: 1.34-3.27) and iii) males not identified as men-who-have-sex-with-men (MSM), HR = 2.99 (95% CI: 2.09-4.27).Identification of HCV first compared to HIV first was independently associated with IDU in males and females OR = 2.83 (95% CI: 1.84-4.37) and 2.25 (95% CI: 1.15-4.39) respectively, but not Aboriginal ethnicity or MSM. HIV was identified first in 22%, with median time to HCV identification of 15 months; The ability to link BC public health and laboratory HIV and HCV information provided a unique opportunity to explore demographic and risk factors associated with HIV/HCV co-infection. Over half of persons with HIV infection who were tested for HCV were anti-HCV positive; half of these had HCV diagnosed first with HIV identification a median 3.5 years later. This highlights the importance of public health follow-up and harm reduction measures for people identified with HCV to prevent subsequent HIV infection.