- 1VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
- 2Weill Cornell Medical College, New York, NY, USA.
- 3Hamad Medical Corporation, Doha, Qatar.
Background: Rate of SARS-CoV-2 infection and impact of liver fibrosis stage upon infection rates in persons with hepatitis C virus (HCV) infection are unknown.
Methods: We retrospectively analyzed the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES), a well-established database of HCV infected Veterans in care. We excluded those with missing FIB-4 score and those with HIV or hepatitis B virus coinfection. We determined the number of persons tested, proportion who tested positive for SARS-CoV-2, and the infection rate by age and liver fibrosis stage.
Results: Among 172,235 persons with HCV, 14,305 (8.3%) were tested for SARS-CoV-2 infection and 892 (6.2%) tested positive. Those with SARS-CoV-2 infection were older, more likely to be Black (55.2% vs. 37.8%), obese (body mass index >30kg/m2 36.2% vs. 29.7%) and have diabetes or stroke (p<0.0001 for all comparisons). Mean FIB-4 scores and proportion of persons with cirrhosis (based on a FIB-4 > 3.25) were similar in both groups. Incidence rate/1,000 tested persons was much higher among Blacks (88.4; 95% CI 81.1,96.2) vs. Whites (37.5; 95% CI 33.1,42.4) but similar among those with cirrhosis (FIB-4>3.25). The rates were also similar among those who were untreated for HCV vs. those treated with or without attaining a sustained virologic response.
Conclusions: Testing rates among persons with HCV are very low. Persons with infection are more likely to be Black, have a higher body mass index and diabetes or stroke. The degree of liver fibrosis does not appear to have an impact on infection rate.