The Burgeoning HIV/HCV Syndemic in the Urban Northeast: HCV, HIV, and HIV/HCV Coinfection in an Urban Setting

PLoS One

PLoS One (2013; doi:10.1371/journal.pone.0064321).

Research Article

Jamie P. Morano mail, Britton A. Gibson, Frederick L. Altice

Abstract

Introduction

Despite recommendations for generation-based HCV and once lifetime HIV screening, thousands of individuals in the U.S. still remain untested and undiagnosed. This cross-sectional study examines the correlates of HCV and HIV monoinfection and HIV/HCV coinfection in an urban Northeast setting.

Methods

Utilizing an electronic database from a mobile medical clinic in New Haven, CT from January 2003 to July 2011, 8,311 individuals underwent structured health assessment and screening for HIV and HCV.

Results

HIV [N = 601 (8.0%)] and HCV [N = 753 (10.1%)] infection were identified, and 197 (26.1%) of the 753 with HCV were coinfected with HIV. Both monoinfection and coinfection status were independently correlated with crack cocaine use and increasing age. HIV/HCV coinfection was correlated with men having sex with men (MSM) (AOR = 38.53, p<0.0080), shooting gallery use (AOR = 3.06, p<0.0070), and not completing high school (AOR = 2.51, p<0.0370). HCV monoinfection correlated with health insurance (AOR = 2.16, p<0.0020), domestic violence (AOR = 1.99, p<0.0070), and being Hispanic (AOR = 2.63, p<0.0001), while HIV monoinfection correlated with having had syphilis (AOR = 2.66, p<0.0001) and being Black (AOR = 1.73, p = 0.0010).

Conclusions

Though HIV and HCV share common transmission risk behaviors, independent correlates with viral infection status in an urban Northeast setting are distinct and have important implications for surveillance, healthcare delivery, disease prevention, and clinical care.

Citation: Morano JP, Gibson BA, Altice FL (2013) The Burgeoning HIV/HCV Syndemic in the Urban Northeast: HCV, HIV, and HIV/HCV Coinfection in an Urban Setting. PLoS ONE 8(5): e64321. doi:10.1371/journal.pone.0064321

Editor: Joan A. Caylà, Public Health Agency of Barcelona, Spain

Received: December 11, 2012; Accepted: April 14, 2013; Published: May 14, 2013

Copyright: © 2013 Morano et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: Funding for the study was provided by the National Institutes on Drug Abuse for Career Development (FLA: K24 DA017072) and Research (FLA: R01 DA030762, R01 DA029910) and The National Institutes of Allergy and Infectious Diseases (JPM: T32 A1007517). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: JPM, BAG, and FLA have declared that no competing interests exist. The authors adhere to all PLOS ONE policies on sharing data and materials.

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