Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana
WHO recommends hepatitis C (HCV) screening for all people living with HIV (PLHIV). Yet, HCV coinfection was shown to be rare in some Sub-Saharan HIV cohorts, and targeted testing was suggested more efficient for such settings. We studied HCV prevalence among Ghanaian PLHIV, and assessed the external...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-05-01
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| Series: | Journal of the International Association of Providers of AIDS Care |
| Online Access: | https://doi.org/10.1177/23259582211022469 |
| _version_ | 1818737565585375232 |
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| author | Kwasi Torpey MD, PhD, MPH, FGCP Lily Ogyiri MPH Vicky Cuylaerts MSc Seth Agyeman BSc, MPhil Adwoa Agyei-Nkansah MD, MPH, FWACP Jozefien Buyze PhD Joseph Oliver Commey MD, MPH, FWACP Lutgarde Lynen MD, PhD Anja De Weggheleire MD, MPH |
| author_facet | Kwasi Torpey MD, PhD, MPH, FGCP Lily Ogyiri MPH Vicky Cuylaerts MSc Seth Agyeman BSc, MPhil Adwoa Agyei-Nkansah MD, MPH, FWACP Jozefien Buyze PhD Joseph Oliver Commey MD, MPH, FWACP Lutgarde Lynen MD, PhD Anja De Weggheleire MD, MPH |
| author_sort | Kwasi Torpey MD, PhD, MPH, FGCP |
| collection | DOAJ |
| description | WHO recommends hepatitis C (HCV) screening for all people living with HIV (PLHIV). Yet, HCV coinfection was shown to be rare in some Sub-Saharan HIV cohorts, and targeted testing was suggested more efficient for such settings. We studied HCV prevalence among Ghanaian PLHIV, and assessed the external validity of a score to guide targeted testing. This score was initially derived from a Cambodian HIV cohort, and uses as predictors: age, household member/partner with liver disease, diabetes, generalized pruritus, AST, platelets, and AST-to-platelet ratio index. We enrolled 4,023 PLHIV, most from Greater Accra and Central regions, 28.4% were male, median age was 47 years, and high-risk behavior was reported to be rare. HCV seroprevalence was 0.57%, and HCV-RNA was detectable in 0.5%. Sequencing revealed genotype 1(b) and 2(q/r) infections. The discriminatory performance of the score was suboptimal in the Ghanaian setting. The area under the curve was 0.69 (95% CI 0.59-0.79). HCV coinfection prevalence was very low in this Ghanaian PLHIV cohort with reported low-risk of onward transmission. To avoid the cost of screening all PLHIV in similar cohorts in resource-constrained settings, further research to develop better tools/scores to guide targeted HCV testing is needed. |
| first_indexed | 2024-12-18T00:55:04Z |
| format | Article |
| id | doaj.art-c96671d3c9a34808b59b046f75490fdf |
| institution | Directory Open Access Journal |
| issn | 2325-9582 |
| language | English |
| last_indexed | 2024-12-18T00:55:04Z |
| publishDate | 2021-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of the International Association of Providers of AIDS Care |
| spelling | doaj.art-c96671d3c9a34808b59b046f75490fdf2022-12-21T21:26:33ZengSAGE PublishingJournal of the International Association of Providers of AIDS Care2325-95822021-05-012010.1177/23259582211022469Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in GhanaKwasi Torpey MD, PhD, MPH, FGCP0Lily Ogyiri MPH1Vicky Cuylaerts MSc2Seth Agyeman BSc, MPhil3Adwoa Agyei-Nkansah MD, MPH, FWACP4Jozefien Buyze PhD5Joseph Oliver Commey MD, MPH, FWACP6Lutgarde Lynen MD, PhD7Anja De Weggheleire MD, MPH8 , Accra, Ghana , Accra, Ghana , Antwerp, Belgium , Accra, Ghana , Accra, Ghana , Antwerp, Belgium LEKMA Hospital, Accra, Ghana , Antwerp, Belgium , Antwerp, BelgiumWHO recommends hepatitis C (HCV) screening for all people living with HIV (PLHIV). Yet, HCV coinfection was shown to be rare in some Sub-Saharan HIV cohorts, and targeted testing was suggested more efficient for such settings. We studied HCV prevalence among Ghanaian PLHIV, and assessed the external validity of a score to guide targeted testing. This score was initially derived from a Cambodian HIV cohort, and uses as predictors: age, household member/partner with liver disease, diabetes, generalized pruritus, AST, platelets, and AST-to-platelet ratio index. We enrolled 4,023 PLHIV, most from Greater Accra and Central regions, 28.4% were male, median age was 47 years, and high-risk behavior was reported to be rare. HCV seroprevalence was 0.57%, and HCV-RNA was detectable in 0.5%. Sequencing revealed genotype 1(b) and 2(q/r) infections. The discriminatory performance of the score was suboptimal in the Ghanaian setting. The area under the curve was 0.69 (95% CI 0.59-0.79). HCV coinfection prevalence was very low in this Ghanaian PLHIV cohort with reported low-risk of onward transmission. To avoid the cost of screening all PLHIV in similar cohorts in resource-constrained settings, further research to develop better tools/scores to guide targeted HCV testing is needed.https://doi.org/10.1177/23259582211022469 |
| spellingShingle | Kwasi Torpey MD, PhD, MPH, FGCP Lily Ogyiri MPH Vicky Cuylaerts MSc Seth Agyeman BSc, MPhil Adwoa Agyei-Nkansah MD, MPH, FWACP Jozefien Buyze PhD Joseph Oliver Commey MD, MPH, FWACP Lutgarde Lynen MD, PhD Anja De Weggheleire MD, MPH Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana Journal of the International Association of Providers of AIDS Care |
| title | Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana |
| title_full | Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana |
| title_fullStr | Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana |
| title_full_unstemmed | Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana |
| title_short | Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana |
| title_sort | hepatitis c prevalence and validation of a clinical prediction score for targeted screening among people living with hiv in ghana |
| url | https://doi.org/10.1177/23259582211022469 |
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