Prevalence of human immunodeficiency virus testing in patients with hepatitis B and C infection.
OBJECTIVE
To determine the proportion of patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) who are adequately assessed for human immunodeficiency virus (HIV) and to identify variables associated with absence of HIV testing.


METHODS
We retrospectively reviewed the medical records of patients who had positive serologic test results for reactive HBV and/or HCV between January 1999 and December 1999 and were followed up at a general internal medicine clinic in East Harlem, NY. Data were collected on patient demographics, HIV risk factors, and other variables that might influence the physician's decision to test the patient for HIV. Primary outcomes were HIV tests performed and documented discussions of at-risk HIV behavior.


RESULTS
The HIV tests were performed in 40% (95% confidence interval [CI], 32%-49%) of the 141 patients with reactive HBV and/or HCV serologic test results. Predictors of HIV testing on multivariate logistic regression were age younger than 50 years (odds ratio [OR], 25; 95% CI, 13-3.8), male sex (OR, 1.6; 95% CI, 1.1-2.2), and having an established primary care provider (OR, 2.3; 95% CI, 1.2-3.9). Injection drug use was not significantly associated with HIV testing.


CONCLUSIONS
Although HBV and HCV have clear epidemiological links with HIV, this study shows that a high percentage of these patients are not being tested. Although some of the factors associated with lack of testing were identified, further studies on the barriers to HIV testing are needed to reveal potential approaches to increase rates of HIV testing in this high-risk population.
Krain
Alysa
A
Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, NY, USA.
Wisnivesky
Juan P
JP
Garland
Elizabeth
E
McGinn
Thomas
T
D000367:Age Factors; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006509:Hepatitis B / Q000097:blood / Q000150:complications*; D006510:Hepatitis B Antibodies / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies