HCV Infection Rate Seems Low in At-Risk Women
By Megan Rauscher
NEW YORK (Reuters Health) Dec 03 - New data from the Women's
Interagency HIV Study (WIHS) suggest that the incidence of hepatitis
C virus (HCV) infection is low among women with, or at risk for,
HIV-1 infection. The data also suggest that HCV is now almost
exclusively linked to drug use, and often resolves.
Dr. Michael Augenbraun from the State University of New
York-Downstate Medical Center in Brooklyn and the multicenter WIHS
team retrospectively screened 1517 stored serum samples for HCV
antibody and viremia from a group of initially HIV-infected,
HCV-uninfected women and from HIV-uninfected, HCV-uninfected women.
"These women were being followed prospectively as part of a large
study of the natural history of HIV infection in women," Dr.
Augenbraun told Reuters Health. "The point was to try to find women
not infected with HCV who subsequently developed infection."
Not many of them did, the researcher said. Over a 3- to 4-year
period, only 22 (1.5%) of 1517 exhibited HCV seroconversion. Of
these, only 14 truly acquired HCV as determined by enzyme immunoassay
and new-onset viremia. Dr. Augenbraun admitted that he was "surprised
that so few women" acquired HCV infection.
The HCV incidence rate in HIV-infected and HIV-uninfected women was
2.7 and 3.3 cases per 1000 person-years, respectively. "Not
surprisingly," Dr. Augenbraun said, "most of the women that acquired
HCV had a history of drug use."
He also noted that in several HIV/HCV-coinfected women, "the
appearance of HCV antibody took many months to years after the
appearance of virus in the serum."
Moreover, "a large portion of HCV-infected women (42%) appeared to
durably clear HCV from their serum, a percentage considerably in
excess of current estimates," Dr. Augenbraun pointed out.
Writing in the November 15th issue of Clinical Infectious Diseases,
the researchers suggest that clinicians "maintain a high index of
suspicion of HCV infection for individuals at risk and consider
repeated antibody testing, as well as HCV RNA testing, when such
individuals have negative results of a single antibody study."
Clin Infect Dis 2003;37:1357-1364.
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