1588Prevalence of and Factors Associated with Hepatitis C Virus Testing and Infection Among HIV-infected Adults Receiving Medical Care in the United States

Background. Hepatitis C Virus (HCV) infection causes substantial morbidity and mortality among HIV-infected persons. Representative prevalence estimates of HCV infection can help inform treatment efforts in the dawning era of highly effective antiHCV therapy. Methods. We used 2009 data from theMedical Monitoring Project, a nationally representative sample of U.S. HIV-infected adults in care, to determine prevalence of HCV testing and infection. We defined HCV testing as documentation of an HCV antibody or RNA test and HCV infection as a positive result. We used bivariate analyses and multivariate logistic regression to examine factors associated with HCV testing and infection. Results. We estimated that 342,952 HIV-infected adults or 81% (95% confidence intervals [CIs]: 304,474—381,430; 79%–84%) were ever tested for HCV. Factors associated independently (p <0.01) with testing included black race, recent HIV diagnosis, and history of AIDS. Among those tested, 21% (95% CI: 18-24%) were infected with HCV. Prevalence varied significantly by age (≥ 44 vs < 44 years: 27 vs 10%), men who have sex with women only (MSW) vs men who have sex with men (MSM) (33 vs 14%), public vs private insurance (28 vs 11%), income at or below poverty level vs not (28 vs 16%), homeless vs not (34 vs 20%), recent injection drug use (IDU) vs not (62 vs 20%), duration of HIV infection (≥ 10 vs <10 years: 27 vs 14%), and history of AIDS vs no AIDS (23 vs 17%). Factors associated independently with HCV infection included recent IDU (adjusted prevalence ratio [APR] 3.2; 95% CI 2.6–3.9), age >44 years (APR 2.2; 95% CI 1.7–2.7], MSW (APR 1.9; 95% CI 1.6-2.3), public insurance (APR 1.6; 95% CI 1.3–2.1), HIV diagnosed ≥10 years (APR 1.5; 95% CI 1.3–1.8), homelessness (APR 1.4; 95% CI 1.1–1.7), and income at or below poverty level (APR 1.3; 95% CI 1.1–1.5). Conclusion. Current U.S. guidelines endorse baseline HCV screening for all HIVinfected persons and routine screening for those with IDU; however, almost 1 in 5 U.S. HIV-infected adults in care have never been tested. HCV infection prevalence varied among sub-groups. All HIV-infected adults, especially those in high-risk groups, should be tested for HCV to increase the number of persons aware of their HCV infection and eligible for potentially curative treatment. Disclosures. All authors: No reported disclosures.