May 15, 2013
A Yale University research team reported identifying a geographical dimension of risk factors common to HIV and hepatitis C virus (HCV) that may influence surveillance, prevention, and healthcare delivery for people coinfected with these viruses. A growing number of people in the US Northeast have both HIV and HCV, the most common chronic viral infections in the nation. Most assessments underestimate HIV and HCV prevalence, because homeless and incarcerated individuals are underrepresented in surveys.
To reach these underrepresented populations, the Yale team studied data collected from 8,300 people who were screened for HCV and HIV at a community healthcare van -- a mobile clinic -- in New Haven, Conn. To single out the risk factors for each virus and for coinfection, the researchers correlated risk factors and Arc GIS mapping techniques.
Of the 8,300 patients, 10 percent had HCV, 8 percent had HIV, and slightly more than 25 percent had HIV and HCV coinfection. The study identified older age and crack cocaine use as risk factors for both HCV and HIV, and for HCV/HIV coinfection. HCV was associated with a history of interpersonal violence and being Hispanic, while HIV infection was linked to having had syphilis. HCV/HIV coinfection also was more likely among men who have sex with men, injection drug users, and those with less than a high school education.
Dr. Jamie Morano and Dr. Frederick Altice, authors of the study, stated that the "synergy of unique risk factors" pointed to the need for distinct models of treatment delivery since these patients rarely use traditional medical care.
The full report, "The Burgeoning HIV/HCV Syndemic in the Urban Northeast: HCV, HIV, and HIV/HCV Coinfection in an Urban Setting," was published online in the journal PLoS One (2013; doi:10.1371/journal.pone.0064321).