Human Immunodeficiency Virus and Hepatitis C Virus Infection Testing Among Commercially Insured Persons Who Inject Drugs, United States, 2010-2017
Human Immunodeficiency Virus and Hepatitis C Virus Infection Testing Among Commercially Insured Persons Who Inject Drugs, United States, 2010-2017
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DOI：
10.1093/infdis/jiaa017
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发表时间：
2020-09-15
影响因子：
6.4
通讯作者：
Hoover, Karen W.
中科院分区：
文献类型：
--
作者：
Bull-Otterson, Lara;Huang, Ya-Lin A.;Hoover, Karen W.
背景。我们评估了注射吸毒者（PWID）中人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）感染检测的流行程度。使用2010-2017年支付的全国健康保险数据库，我们通过使用国际疾病分类、现行程序术语和国家药品代码目录中的代码来确定PWID。然后，我们估计了在一次指数接触后1年内接受HIV或HCV检测的PWIDs的百分比，我们使用多变量逻辑回归模型来评估与检测相关的人口统计学和临床因素。在844242名无艾滋病毒感染者中，71 938人（8.5%）接受了艾滋病毒检测，65 188人（7.7%）接受了丙型肝炎病毒感染检测。错失机会与男性独立相关（比值比[ORs]: HIV， 0.50[95%可信区间{CI}， 0.49-0.50], P < 0.001； HCV, 0.66 [95% CI, 0.65-0.72], P < 0.001）、农村居住（比值比：HIV， 0.67 [95% CI, 0.65-0.69], P < 0.001； HCV, 0.75 [95% CI, 0.73-0.77], P < 0.001），以及接受皮肤感染或心内膜炎服务（调整比值比：HIV， 0.91 [95% CI, 0.87-0.95], P < 0.001； HCV, 0.90 [95% CI, 0.86-0.95], P < 0.001）。大约90%的推定PWIDs患者错过了HIV或HCV检测的机会，特别是声称皮肤感染或心内膜炎的男性农村居民，通常与注射药物使用有关。
Background. We assessed prevalence of testing for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection among persons who inject drugs (PWID).Methods. Using a nationwide health insurance database for claims paid during 2010-2017, we identified PWID by using codes from the International Classification of Diseases, Current Procedural Terminology, and National Drug Codes directory. We then estimated the percentage of PWIDs tested for HIV or HCV within 1 year of an index encounter, and we used multivariate logistic regression models to assess demographic and clinical factors associated with testing.Results. Of 844 242 PWIDs, 71 938 (8.5%) were tested for HIV and 65 188 (7.7%) were tested for HCV infections. Missed opportunities were independently associated with being male (odds ratios [ORs]: HIV, 0.50 [95% confidence interval {CI}, 0.49-0.50], P < .001; HCV, 0.66 [95% CI, 0.65-0.72], P < .001), rural residence (ORs: HIV, 0.67 [95% CI, 0.65-0.69], P < .001; HCV, 0.75 [95% CI, 0.73-0.77], P < .001), and receiving services for skin infections or endocarditis (adjusted ORs: HIV, 0.91 [95% CI, 0.87-0.95], P < .001; HCV, 0.90 [95% CI, 0.86-0.95], P < .001).Conclusions. Approximately 90% of presumed PWIDs missed opportunities for HIV or HCV testing, especially male rural residents with claims for skin infections or endocarditis, commonly associated with injection drug use.