title: Hepatitis C Screening in People With Human Immunodeficiency Virus: Lessons Learned From Syphilis Screening.
abstract: Background.  The incidence of hepatitis C virus (HCV) infection is increasing in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). New guidelines recommend annual screening for HCV, similar to recommendations for syphilis screening with rapid plasma reagin (RPR). Methods.  This study compares the frequency of repeat HCV antibody (Ab) testing to repeat RPR testing in a retrospective chart review of 359 HCVAb-negative people living with HIV (PLWH) observed in an Infectious Diseases clinic. Patients were classified into risk groups based on sexual risk factors. Results.  Although 85% of PLWH had repeat syphilis screening, less than two thirds had repeat HCVAb screening. The MSM status was associated with increased HCVAb and RPR testing (adjusted odds ratio, 2.6 and 5.9, respectively). Seven persons had incident HCV infection: 3 were MSM, and 4 had symptoms or abnormal laboratory results to prompt testing. Conclusions.  Failure to find incident HCV infection in PLWH represents missed opportunities to cure HCV infection and prevent progressive liver disease. Further quality improvement studies are necessary to develop physician-focused interventions to increase HCV screening rates in PLWH.
authors.affiliation: Department of Geographic Medicine and Infectious Diseases, Tufts Medical Center; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Alysse G
authors.initials: AG
authors.lastname: Wurcel
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Chen
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Rosemary E
authors.initials: RE
authors.lastname: Fitzpatrick
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Paula E
authors.initials: PE
authors.lastname: Grasberger
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Caleb H
authors.initials: CH
authors.lastname: Kirshner
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Anderson
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Kenneth K H
authors.initials: KK
authors.lastname: Chui
authors.affiliation: Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Tamsin A
authors.initials: TA
authors.lastname: Knox
keywords: HIV; MSM; hepatitis C; syphilis