HIV testing in patients who are HCV positive: Compliance with CDC guidelines in a large healthcare system.

MedStar author(s):
Citation: PLoS ONE [Electronic Resource]. 16(6):e0252412, 2021.PMID: 34077476Institution: MedStar Health Research Institute | MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine/Infectious Diseases | MedStar Institute for Quality and SafetyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021Local holdings: Available online through MWHC library: 2006 - presentISSN:
  • 1932-6203
Name of journal: PloS oneAbstract: BACKGROUND: There are approximately 300,000 people in the United States who are co-infected with HIV and HCV. Several organizations recommend that individuals who are HCV infected, as well as persons over the age of 13, should be HIV tested. Comorbidities associated with HCV can be reduced with early identification of HIV. Our objective was to determine whether providers routinely followed HIV testing guidelines for patients who tested HCV positive (HCV+).CONCLUSION: As demonstrated, providers did not routinely follow CDC recommendations as almost half of the HCV+ patients were not correctly tested for HIV. It is important to emphasize that six persons were tested HIV positive simultaneously with their HCV+ diagnosis. If providers did not follow the CDC guidelines, then these patients may not have been identified. Improvements in EHR clinical decision support tools and provider education can help improve the HIV testing rate among individuals who are HCV+.METHODS: A retrospective chart review was conducted of all patients in primary care at an academic health system from 7/2015-3/2017 who tested HCV+. As part of a primary database, HCV testing data was collected; HIV testing data was abstracted manually. We collected and described the intervals between HCV and HIV tests. To determine associations with HIV testing univariable and multivariable analyses were performed.RESULTS: We identified 445 patients who tested HCV+: 56.6% were tested for HIV, the mean age was 57 +/- 10.9 years, 77% were from the Birth Cohort born 1945-1965 (BC); 61% were male; and 51% were Black/AA. Patients in the BC were more likely to be HIV tested if they were: male (p = 0.019), Black/AA (p<0.001), and had Medicaid (p = 0.005). These differences were not found in the non-BC. Six patients who were tested for both HIV and HCV were found to be newly HIV positive at the time of testing.All authors: Basch P, Desale S, Fernandez S, Fishbein DA, Fleisher I, Geboy AG, Nichols WFiscal year: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-06-28
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34077476 Available 34077476

Available online through MWHC library: 2006 - present

BACKGROUND: There are approximately 300,000 people in the United States who are co-infected with HIV and HCV. Several organizations recommend that individuals who are HCV infected, as well as persons over the age of 13, should be HIV tested. Comorbidities associated with HCV can be reduced with early identification of HIV. Our objective was to determine whether providers routinely followed HIV testing guidelines for patients who tested HCV positive (HCV+).

CONCLUSION: As demonstrated, providers did not routinely follow CDC recommendations as almost half of the HCV+ patients were not correctly tested for HIV. It is important to emphasize that six persons were tested HIV positive simultaneously with their HCV+ diagnosis. If providers did not follow the CDC guidelines, then these patients may not have been identified. Improvements in EHR clinical decision support tools and provider education can help improve the HIV testing rate among individuals who are HCV+.

METHODS: A retrospective chart review was conducted of all patients in primary care at an academic health system from 7/2015-3/2017 who tested HCV+. As part of a primary database, HCV testing data was collected; HIV testing data was abstracted manually. We collected and described the intervals between HCV and HIV tests. To determine associations with HIV testing univariable and multivariable analyses were performed.

RESULTS: We identified 445 patients who tested HCV+: 56.6% were tested for HIV, the mean age was 57 +/- 10.9 years, 77% were from the Birth Cohort born 1945-1965 (BC); 61% were male; and 51% were Black/AA. Patients in the BC were more likely to be HIV tested if they were: male (p = 0.019), Black/AA (p<0.001), and had Medicaid (p = 0.005). These differences were not found in the non-BC. Six patients who were tested for both HIV and HCV were found to be newly HIV positive at the time of testing.

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