New York Veterans Suffer High Rates of Hepatitis C With HIV Infection

Veterans in New York have an alarmingly high rate of hepatitis C virus (HCV) and HIV infection, according to a study published in American Journal of Gastroenterology ("Prevalence of Hepatitis C and Coinfection with HIV Among United States Veterans in the New York City Metropolitan Area," 2002;97(8):2071-2078).

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, and Castle Point, N.Y., and East Orange and Lyons, N.J., examined "the prevalence of coinfection with HIV and its risk factors, among patients with confirmed HCV infection." HIV/HCV coinfection was common enough -- almost a quarter of patients with HCV antibodies were coinfected with HIV -- to warrant routine testing in HCV-infected patients, Brau and coauthors found.

The researchers surveyed nearly 2,000 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. More than 10 percent of the patients who agreed to be screened tested positive for HCV antibodies, and active HCV viremia was found in more than 8 percent of tested patients, data showed. Most infected patients carried HCV type one, with this genotype seen in almost 90 percent of viremic patients. Injection drug use was a strong independent risk factor for HCV infection, researchers noted, as were alcohol abuse and Vietnam-era service.

"US 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."

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