Rates and Characteristics of SARS‐CoV‐2 Infection in Persons with Hepatitis C Virus Infection

Butt, Adeel A.; Yan, Peng

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/m(2) 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.