PREVALENCE OF ANTIBODY TO HEPATITIS-C VIRUS (HCV) IN HIV-1-INFECTED PATIENTS (NICE SEROCO COHORT)

The prevalence of antibody to hepatitis C virus (HCV) in a cohort of 272 HIV-infected patients was assessed by means of 4 anti-HCV assays: a Ist generation and a neutralization test, a 2nd generation test, and a confirmatory test, the dot-blot Matrix HCV(TM) immunoassay. The cohort included, as a single risk factor, 35.7% intravenous drug users (IVDUs), 25% homosexual men, 30.1% heterosexual individuals, 5.9% transfused patients, 0.7% occupational infections, and 2.6% patients with unknown infection source, and was studied on entry and in samples collected for up to 36 months. Results showed that on entry (i) sera of 83 out of 272 members of the cohort were positive by the HCV Ist generation EIA (30.5%); 70 were confirmed by the neutralization test (84.3%); (ii) 115 of the cohort were reactive with the 2nd generation HCV EIA (41.3%); (iii)with the dot-blot immunoassay 99 (86.1%) of the cohort were confirmed and 16 remained indeterminate. The overall confirmed HCV antibody-positive rate in these 272 patients was 36.4%. Antibody to HCV was detected in 78.3% of IVDUs, 18.3% of heterosexual individuals, 31.2% of transfused patients, and only 2.9% of homosexual men. The 36-month follow-up of this cohort revealed that 4/145 patients became anti-HCV positive by second generation assay. Hepatitis B markers were frequently associated with HCV in IVDUs (71.1%) but infrequently in heterosexual (8.5%)or homosexual (1.5%) individuals. Our results suggest that HCV 2nd generation EIA used in combination with the semiautomated dot-blot assay as a confirmatory test improves the specificity and sensitivity for HCV antibody detection. Homosexual males are at low risk of HCV infection among HIV risk groups,