HIV Co-Testing Among Veterans with Chronic Hepatitis C in the Veterans Health Administration

Bret E. Fuller*, 1, 2, 3, Veronica L. Rodriguez1, Alex Linke1, Peter Hauser4
1 Portland VA Medical Center, Portland, Oregon 97239, USA
2 Oregon Health & Science University Department of Public Health and Preventive Medicine, Portland, Oregon 97239, USA
3 NW Hepatitis C Resource Center, VAMC, Portland, Oregon 97239, USA
4 VISN 22 Network Office; 300 Oceangate, Suite 700, Long Beach, California 90802, USA

© 2011 Fuller et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: * Address correspondence to this author at the Portland VA Medical Center, Portland, Oregon 97239, USA. E-mail:;


Objective: This retrospective study analyzed the testing rates of individuals enrolled in the Hepatitis C Clinical Case Registry for the Veterans Health Administration (VHA) in order to determine Human Immunodeficiency Virus (HIV) co-testing rates for veterans with hepatitis C (HCV). Design: A chart review of 247,006 veterans enrolled in the National HCV Clinical Case Registry was examined retrospectively. Regression analysis identified factors that increased the probability of being tested for HIV. Methods: Simple odds ratios and a complex regression were applied to this dataset to calculate testing incidence and prevalence of HIV. Results: Only approximately one third of veterans with HCV were tested for HIV and, of these, 13.2% were positive. Sixty eight percent of veterans with HCV were not co-tested for HIV and within this group there may be a significant number of unidentified cases of HIV. Veterans with severe mental illness, substance use disorders and marijuana abuse/dependence treatment were more likely to be tested for HIV. Antiviral therapy for HCV had no impact on likelihood of co-testing prior to treatment initiation. Conclusions: Most veterans with HCV are not co-tested for HIV despite common risk factors for HIV and HCV infection. Mandatory testing for HIV, at least among veterans with HCV, as well as identification and removal of barriers to HIV testing within the VHA would serve to facilitate disease management for veterans in the future.

Keywords: HIV, hepatitis C, testing.