Epidemiology

HCV infection rate seems low in at-risk women

Last Updated: 2003-12-03 14:48:28 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - 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.