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Background Hepatitis C virus (HCV) infection is the most common bloodborne infection in the U.S. However, only a small proportion of persons are treated and cured. Previous research has not characterized sociodemographic characteristics of who receives treatment. We examined predictors of undetectable for HCV in Orange County, the sixth largest county in the United States, where HCV is the most commonly reported infection.MethodsFrom 2014 to 2020, we acquired public health surveillance data from 91,165 HCV antibody-positive care encounters from the California Reportable Disease Information Exchange (CalREDIE). We used a time-to-event proportional hazards framework to estimate individual and area-level correlates of time-to-HCV undetectable viral load among HCV + individuals.ResultsOlder adults (>65 years) showed an increased hazard of undetectable viral load relative to younger adults (HR = 2.00). In addition, residents of census tracts with greater enrollment in health insurance showed a greater likelihood of undetectable viral load (HR = 1.36). The moderating effect of higher tract median household income and higher tract levels of health insurance were more likely to have undetectable viral load and was statistically significant.ConclusionIn a large urban county, HCV antibody-positive older adults appear much more likely to show undetectable viral load compared to younger adults. Residents in areas with higher quartiles of health insurance enrollment have an increased likelihood of undetectable viral load. The extent to which constraints impede HCV care requires further investigation, including follow-up studies on health insurance type to test the relationship of health insurance type to undetectable viral load.

Background Hepatitis C virus (HCV) infection is the most common bloodborne infection in the U.S. However, only a small proportion of persons are treated and cured. Previous research has not characterized sociodemographic characteristics of who receives treatment. We examined predictors of undetectable for HCV in Orange County, the sixth largest county in the United States, where HCV is the most commonly reported infection.MethodsFrom 2014 to 2020, we acquired public health surveillance data from 91,165 HCV antibody-positive care encounters from the California Reportable Disease Information Exchange (CalREDIE). We used a time-to-event proportional hazards framework to estimate individual and area-level correlates of time-to-HCV undetectable viral load among HCV + individuals.ResultsOlder adults (>65 years) showed an increased hazard of undetectable viral load relative to younger adults (HR = 2.00). In addition, residents of census tracts with greater enrollment in health insurance showed a greater likelihood of undetectable viral load (HR = 1.36). The moderating effect of higher tract median household income and higher tract levels of health insurance were more likely to have undetectable viral load and was statistically significant.ConclusionIn a large urban county, HCV antibody-positive older adults appear much more likely to show undetectable viral load compared to younger adults. Residents in areas with higher quartiles of health insurance enrollment have an increased likelihood of undetectable viral load. The extent to which constraints impede HCV care requires further investigation, including follow-up studies on health insurance type to test the relationship of health insurance type to undetectable viral load.

In the European Union, it is estimated that there are 5.5 million individuals with chronic infection of hepatitis C. Intravenous drug abuse is undoubtedly the key source of the hepatitis C epidemic in Europe and the most efficient mode of transmission of HCV infections (primarily due to short incubation time, but also because the virus is introduced directly into the blood stream with the infected needle). Potentially high-risk and vulnerable populations in Europe (and the world) include immigrants, prisoners, sex workers,men having sex withmen, individuals infected with HIV, psychoactive substance users etc. Since there is a lack of direct evidence of clinical benefits of HCV testing, decisions related to testing are made based on indirect evidence. Clinical practice has shown that HCV antibody tests are mostly adequate for identification of HCV infection, but the problem is that this testing strategy does not hit the target. As a result of this health care system strategy, a large number of infected patients remain undetected or they are diagnosed late. There is only a vague link between screening and treatment outcomes since there is a lack of evidence on transmission risks, multiple causes, risk behavior, ways of reaching screening decisions, treatment efficiency, etc. According to results of limited number of studies it can be concluded that there is a need to develop targeted programmes for detection of HCV and other infections, but there also a need to decrease potential harms.

In the European Union, it is estimated that there are 5.5 million individuals with chronic infection of hepatitis C. Intravenous drug abuse is undoubtedly the key source of the hepatitis C epidemic in Europe and the most efficient mode of transmission of HCV infections (primarily due to short incubation time, but also because the virus is introduced directly into the blood stream with the infected needle). Potentially high-risk and vulnerable populations in Europe (and the world) include immigrants, prisoners, sex workers,men having sex withmen, individuals infected with HIV, psychoactive substance users etc. Since there is a lack of direct evidence of clinical benefits of HCV testing, decisions related to testing are made based on indirect evidence. Clinical practice has shown that HCV antibody tests are mostly adequate for identification of HCV infection, but the problem is that this testing strategy does not hit the target. As a result of this health care system strategy, a large number of infected patients remain undetected or they are diagnosed late. There is only a vague link between screening and treatment outcomes since there is a lack of evidence on transmission risks, multiple causes, risk behavior, ways of reaching screening decisions, treatment efficiency, etc. According to results of limited number of studies it can be concluded that there is a need to develop targeted programmes for detection of HCV and other infections, but there also a need to decrease potential harms.

Background: B-cell non-Hodgkin lymphoma (NHL) in HIV populations (AIDS-NHL) has become the leading cause of AIDS-defining cancers. Studies suggested that genetic or serum markers of B-cell activation are related to AIDS-NHL. However, associations between HIV viral load and AIDS-NHL risk have not been explicitly explored with consideration of B-cell activation markers. Furthermore, associations of hepatitis C virus (HCV) infection to AIDS-NHL risk are inconclusive. Methods: We used two nested case-control studies within the Multicenter AIDS Cohort Study - the genetic association study including 183 AIDS-NHL cases and 533 matched HIV-positive controls, and the serum cytokine study of 179 AIDS-NHL cases and 179 HIV-infected controls - to explore associations between HIV viral load or HCV infection and AIDS-NHL risk. To screen out possible B-cell activation biomarkers, we implemented weighted gene co-expression network analysis (WGCNA) and visANT. We explored three HIV viral load measurements: (1) viral load at set point, indicating a balance between HIV viral replication and clearance, (2) pre-HAART viral load closest and prior to AIDS-NHL diagnosis, and (3) slope and intercept for linear regression on viral load by year. HCV infection was measured at multiple time-points retrospectively using stored serum specimen or prospectively since 2001. We calculated odds ratios (ORs) and 95% confidence interval (CIs), using conditional logistic regression models including potential confounders and additional single nucleotide polymorphisms (SNPs) or serum cytokines levels suggested by the WGCNA. Results: The WGCNA screened out sCD27, sCD30, and CXCL13 from 328 SNPs and 31 cytokines measured longer than 3-year preceeding AIDS-NHL diagnosis. One-unit increase of log10-HIV RNA at set point was associated with an increased AIDS-NHL risk (SNPs adjusted OR: 2.01; 95% CI: 1.35-2.99, sCD27 and sCD30 adjusted OR: 3.65; 95% CI: 1.52-8.72). Ever HCV infection was possibly associated with

Background: B-cell non-Hodgkin lymphoma (NHL) in HIV populations (AIDS-NHL) has become the leading cause of AIDS-defining cancers. Studies suggested that genetic or serum markers of B-cell activation are related to AIDS-NHL. However, associations between HIV viral load and AIDS-NHL risk have not been explicitly explored with consideration of B-cell activation markers. Furthermore, associations of hepatitis C virus (HCV) infection to AIDS-NHL risk are inconclusive. Methods: We used two nested case-control studies within the Multicenter AIDS Cohort Study - the genetic association study including 183 AIDS-NHL cases and 533 matched HIV-positive controls, and the serum cytokine study of 179 AIDS-NHL cases and 179 HIV-infected controls - to explore associations between HIV viral load or HCV infection and AIDS-NHL risk. To screen out possible B-cell activation biomarkers, we implemented weighted gene co-expression network analysis (WGCNA) and visANT. We explored three HIV viral load measurements: (1) viral load at set point, indicating a balance between HIV viral replication and clearance, (2) pre-HAART viral load closest and prior to AIDS-NHL diagnosis, and (3) slope and intercept for linear regression on viral load by year. HCV infection was measured at multiple time-points retrospectively using stored serum specimen or prospectively since 2001. We calculated odds ratios (ORs) and 95% confidence interval (CIs), using conditional logistic regression models including potential confounders and additional single nucleotide polymorphisms (SNPs) or serum cytokines levels suggested by the WGCNA. Results: The WGCNA screened out sCD27, sCD30, and CXCL13 from 328 SNPs and 31 cytokines measured longer than 3-year preceeding AIDS-NHL diagnosis. One-unit increase of log10-HIV RNA at set point was associated with an increased AIDS-NHL risk (SNPs adjusted OR: 2.01; 95% CI: 1.35-2.99, sCD27 and sCD30 adjusted OR: 3.65; 95% CI: 1.52-8.72). Ever HCV infection was possibly associated with

The association between hepatitis C virus (HCV) infection and risk of malignant lymphoma remains controversial, perhaps due to small-sized studies and low prevalence of HCV in the general population. On the basis of a large Danish-Swedish population-based case-control study, 2,819 lymphoma patients and 1,856 controls of second-generation Danish-Swedish origin were screened for HCV infection using an enzyme-linked immunosorbent assay and a confirming recombinant immunoblot assay (RIBA) test. Positive samples were tested with real-time PCR for the presence of HCV RNA. The association between HCV infection and risk of malignant lymphoma was assessed by logistic regression. When intermediate RIBA test results were interpreted as positive, anti-HCV antibody positivity was associated with a nonsignificant increased risk of non-Hodgkin lymphoma (NHL) overall (odds ratio (OR) = 2.2; 95% confidence interval (CI) 0.9-5.3; n = 20 cases), of B-cell lymphomas combined (OR = 2.4 [1.0-5.8]; n = 20) and of lymphoplasmacytic lymphoma (OR = 5.2 [1.0-26.4]; n = 2). No patients with T-cell or Hodgkin lymphoma were HCV-positive. A more conservative definition of HCV positivity (disregarding intermediate RIBA results) resulted in an OR = 1.6 (0.3-8.5; n = 5) for NHL overall. When the definition was further restricted to require HCV RNA positivity, OR was 1.7 (0.2-16.2; n = 3) for NHL overall. Our findings from a population with a low prevalence of HCV suggest a positive association between HCV and risk of NHL, in particular of B-cell origin.

The association between hepatitis C virus (HCV) infection and risk of malignant lymphoma remains controversial, perhaps due to small-sized studies and low prevalence of HCV in the general population. On the basis of a large Danish-Swedish population-based case-control study, 2,819 lymphoma patients and 1,856 controls of second-generation Danish-Swedish origin were screened for HCV infection using an enzyme-linked immunosorbent assay and a confirming recombinant immunoblot assay (RIBA) test. Positive samples were tested with real-time PCR for the presence of HCV RNA. The association between HCV infection and risk of malignant lymphoma was assessed by logistic regression. When intermediate RIBA test results were interpreted as positive, anti-HCV antibody positivity was associated with a nonsignificant increased risk of non-Hodgkin lymphoma (NHL) overall (odds ratio (OR) = 2.2; 95% confidence interval (CI) 0.9-5.3; n = 20 cases), of B-cell lymphomas combined (OR = 2.4 [1.0-5.8]; n = 20) and of lymphoplasmacytic lymphoma (OR = 5.2 [1.0-26.4]; n = 2). No patients with T-cell or Hodgkin lymphoma were HCV-positive. A more conservative definition of HCV positivity (disregarding intermediate RIBA results) resulted in an OR = 1.6 (0.3-8.5; n = 5) for NHL overall. When the definition was further restricted to require HCV RNA positivity, OR was 1.7 (0.2-16.2; n = 3) for NHL overall. Our findings from a population with a low prevalence of HCV suggest a positive association between HCV and risk of NHL, in particular of B-cell origin.

Objective: To analyze the impact of seropositivity with hepatitis C virus (HCV) on in vitro fertilization (IVF) outcomes. Design: Retrospective, case-controlled study. Setting: Fertility clinic of academic hospital. Patient(s): 42 IVF/intracytoplasmic sperm injection cycles in HCV-seropositive women and 84 matched control cycles. Intervention(s): IVF/intracytoplasmic sperm injection treatment for infertility. Main Outcome Measure(s): Ovarian response to stimulation, laboratory findings, and implantation and pregnancy rates. Result(s): Absence of ovarian response was statistically significantly higher for HCV-seropositive women compared with controls (10/42 vs 5/84 cycles, respectively). For cycles with oocyte retrieval, HCV-seropositive women required more gonadotropin units compared with controls. The maximum estradiol levels and number of collected oocytes were similar, but HCV-seropositive women had statistically significantly fewer embryos available compared with controls. Embryo morphologic features, number of transferred embryos, and rates of implantation and pregnancy were similar for HCV-seropositive women and controls. Conclusion(s): When compared with matched uninfected controls, HCV-seropositive women display a decreased ovarian response. © 2007 American Society for Reproductive Medicine., SCOPUS: ar.j, info:eu-repo/semantics/published

Objective: To analyze the impact of seropositivity with hepatitis C virus (HCV) on in vitro fertilization (IVF) outcomes. Design: Retrospective, case-controlled study. Setting: Fertility clinic of academic hospital. Patient(s): 42 IVF/intracytoplasmic sperm injection cycles in HCV-seropositive women and 84 matched control cycles. Intervention(s): IVF/intracytoplasmic sperm injection treatment for infertility. Main Outcome Measure(s): Ovarian response to stimulation, laboratory findings, and implantation and pregnancy rates. Result(s): Absence of ovarian response was statistically significantly higher for HCV-seropositive women compared with controls (10/42 vs 5/84 cycles, respectively). For cycles with oocyte retrieval, HCV-seropositive women required more gonadotropin units compared with controls. The maximum estradiol levels and number of collected oocytes were similar, but HCV-seropositive women had statistically significantly fewer embryos available compared with controls. Embryo morphologic features, number of transferred embryos, and rates of implantation and pregnancy were similar for HCV-seropositive women and controls. Conclusion(s): When compared with matched uninfected controls, HCV-seropositive women display a decreased ovarian response. © 2007 American Society for Reproductive Medicine., SCOPUS: ar.j, info:eu-repo/semantics/published