Document Type

Capstone Experience

Graduation Date

12-2018

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Col. Ted Cieslak

Second Committee Member

Wichman, Christopher S

Third Committee Member

Dennis Leschinsky

Abstract

Background: Previous studies have shown high prevalence of HCV infection among people living with HIV infection. Coinfected people are at risk of developing liver diseases resulting an increase rate of mortality. Several risk factors for HIV/HCV coinfection have previously been identified with injecting drug users (IDU) as the common route of exposure.

Methods: This was cross -sectional study using HIV and HCV registries maintained by Nebraska Department of Health and Human Services (NE DHHS) from1997 to 2017. A descriptive analysis was used to characterize the sample. Chi-squared test and Fisher exact test were selected to compare the different groups. Univariate and multiple variable logistic regression model chose for the analytical analysis for association between variables.

Results: Of 3256 persons with HIV, 356 were coinfected with HCV resulting a proportion of 11%. Based on HIV diagnosis, 52% persons were coinfected by HCV after being diagnosed with HIV while 48% acquired their HCV before becoming infected with HIV. Exposure by IDU (OR=3.8, 95% CI:2.6-6.7), IDU & Heterosexual contact (OR=3.3, 95% CI:1.8-5.8), MSM & heterosexual contact (OR=2.7, 95% CI:1.1-6.7), MSM & IDU (OR=4.5, 95% CI:2.7-7.5) and all three factors MSM & IDU & Heterosexual contact (OR=4.8, 95% CI:2.1-11.1) had higher odds of HIV/HCV coinfection compare to heterosexual contact alone. MSM alone was not a statistically significant risk factor for coinfection. The 56 years and above age group had highest odds of HCV coinfection. Moreover, coinfected persons had 1.87 odds of dying (95% CI: 1.42-2.45) compared to those with HIV alone.

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