AIDSWEEKLY Plus; November 4, 2002
Michael Greer, Senior Medical Writer

Norbert Brau and colleagues at Veterans Affairs Medical Centers in the Bronx, New York City and Brooklyn, and Veterans Affairs Healthcare Systems in Hudson Valley, Montrose, Castle Point, New York and East Orange and Lyons, New Jersey examined "the prevalence of hepatitis C virus (HCV) infection and its risk factors, as well as the prevalence of coinfection with HIV and its risk factors, among patients with confirmed HCV infection."

Veterans receiving care at VA facilities suffered from hepatitis C at significantly elevated rates, and HIV coinfection was common enough to warrant routine testing in HCV-infected patients, Brau and coauthors found.

The reserarchers surveyed nearly 2000 patients undergoing phlebotomies at six Veterans Affairs Medical Centers in the New York City metropolitan area. Just over half of these patients agreed to be tested for HCV and to provide demographic and risk factor data, according to the report.

More than 10% of the patients who agreed to be screened tested positive for anti-HCV antibodies, and active HCV viremia was found in more than 8% of tested patients, study data showed. Most infected patients carried HCV type 1, with this genotype seen in almost 90% of viremic patients. Injection drug use was a strong independent risk factor for HCV infection, the researchers noted, as were alcohol abuse and Vietnam-era service.

Almost a quarter of the patients with anti-HCV antibodies were infected with HIV (Prevalence of hepatitis C and coinfection with HIV among United States veterans in the New York city metropolitan area. Am J Gastroenterol 2002 Aug;97(8):2071-8.

"U.S. veterans who are receiving medical care at VA medical centers in the New York City metropolitan area have a much higher rate of chronic hepatitis C than the general population, with a high frequency of genotype 1," Brau and colleagues concluded. "Coinfection with HIV is very common in patients with confirmed HCV infection, and these patients should routinely be offered HIV testing."

The corresponding author for this report is Norbert Brau, Veterans Affairs Medical Center, Infectious Disease Section 111F, 130 W. Kingsbridge Rd., Bronx, NY 10468, USA.

Key points reported in this study include:

• Veterans in New York have an alarmingly high rate of hepatitis C virus (HCV) and HIV infection

• More than 10% of patients screened at New York Veterans Affairs centers were infected with HCV, a much higher rate than that seen in the general population

• Almost a quarter of these patients were coinfected with HIV

This article was prepared by AIDS Weekly editors from staff and other reports.

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