HCV Seropositivity Research Articles

Hepatitis C virus and human immunodeficiency virus coinfection among attendants of voluntary counseling and testing centre and HIV follow up clinics in Mekelle Hospital.

IntroductionHepatitis C virus remains a large health care burden to the world. HIV and HCV coinfection is major global health concern worldwide. However, there is limited information on the prevalence of HCV/HIV co-infection in Ethiopia. The aim of the study was to assess the magnitude of HIV/HCV coinfection and the potential risk factors in attendants of voluntary counseling and testing centre and HIV follow up clinics of Mekelle hospital.MethodsA cross sectional seroprevalence survey of HCV infection was carried out on 300 HIV negative and positive subjects attending voluntary counseling and testing (VCT) center and HIV follow up clinics of Mekelle hospital, Ethiopia from December 2010-February 2011. Serum samples were tested for anti-HCV antibodies using immunochromatographic test.ResultsOf the 300 study participants, 126(42%) were HIV negative and 174(58%) HIV seropositive from VCT and HIV follow up clinics, respectively. The overall anti-HCV prevalence was 18(6.0%). There were no significant differences in HCV seroprevalence among the different categories of age and sex (p> 0.05). Of the 174 persons with HIV, 16 (9.2%) cases had antibodies to HCV, where as among 126 HIV negative subjects 2 (1.58%) were HCV seropositive (p= 0.006, OR= 6.28, 95% CI= 1.42-27.82).ConclusionAccordingly, there was a significant difference in sero-positivity of HCV between HIV positive and HIV negative participants. No apparent risk factor that caused HCV infection was inferred from this study.

Safety of blood and components obtained from voluntary and replacement donors: a comparative analysis

A eight and half year retrospective study from January, 2005 to June, 2013 was conducted in the blood bank of Shri Mahant Indiresh Hospital under the department of pathology of Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India. Donors were screened for seroprevalence of HIV, HBV, HCV and Syphilis. The sera of total 12716 donors were tested, out of these 6592(51.8%) were from voluntary while 6124(48.2%) were towards replacement donors. The incidence of HIV was 0.17 % in total donors, more in replacement (0.12%) as compared to voluntary (0.05%). The seroprevalence of HBsAg in total donors was 0.72 %. Comparable results were seen in both types of donors. The seropositivity for anti HCV was (0.55%) and was found to be higher in replacement donors (0.43%) .The seroprevalence of VDRL was 0.50 % in total donors, more in replacement donors (0.35%) as compared to voluntary donors (0.15%). Hence, it was concluded that voluntary donation is safer than replacement donation.

OCCUPATIONAL HEALTH-RELATED MORBIDITIES AMONG STREET SWEEPERS AND WASTE COLLECTORS AT BENI-SUEF, EGYPT

Introduction: Street sweepers play an important role in maintaining the health and hygiene in the communities. However, their job exposes them to various hazards while, little or no attention is paid to their health status. Aim of the work: To study the possible work-related morbidities among street sweepers and waste collectors emphasizing on the occupational risks they are exposed to and the preventive measures they take to avoid their job-related hazardous exposures. Materials and Methods: A total of 138 street sweepers and waste collectors and a matching control group of randomly selected 127 university workers and clerks were interviewed, answered the study questionnaire, and had medical examination, then they offered blood and stool samples for laboratory investigations. Results: Compared to the control group, street sweepers and waste collectors had significantly higher rates of HCV seropositivity, parasitic infestations, skin irritation, respiratory complaints and work-related injuries; but with significantly lower mean hemoglobin levels, (p<0.05).However, no significant difference was detected for HBV infection, eye complaints, joint or lower back pains. Most of street sweepers had never been medically examined, vaccinated, trained for safety practices or even health educated regarding their occupation-related health hazards. Conclusion: Street sweeping and waste collection is a hazardous job that exposes its workers to infections especially with the little, in any, protective measures they apply. Guidelines for safety measures and controlling infections should be emphasized and employed for those workers, while offering periodic medical examinations and supplying them with personal protective equipments.

The Impact of HCV Sero-Positivity of Recipients on Clinical Outcomes Following Allogeneic HSCT in Japan

The Impact of HCV Sero-Positivity of Recipients on Clinical Outcomes Following Allogeneic HSCT in Japan

Co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors in Kathmandu, Nepal

Background: HIV, HBV, Syphilis and HCV share common modes of transmission.Objective: The study was aimed to determine the co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors.Methods: The study was conducted on blood samples screened as HCV seropositive at Nepal Red Cross Society, Central Blood Transfusion Service, Kathmandu, Nepal. HCV seropositive samples were further tested for HIV, HBV and Syphilis.Results: Eight co-infections were observed in 139 HCV seropositives with total co-infection rate of 5.75% (95% CI = 2.52-11.03).Conclusion: Co-infection of HIV, HBV and Syphilis with HCV is prevalent in the healthy looking blood donors of Kathmandu, Nepal.

Intrafamilial seropositivity of hepatitis in patients with hepatitis B and C virus in hepatitis clinic in Hamadan, Iran

Objective. To determine intrafamilial seropositivity of HBV and HCV and to compare them in families of infected persons with HBV and HCV in Hamadan clinic of hepatitis.Material and methods. In this analytic cross-sectional study, 651 family members of 200 HBV and HCV infection index cases were entered into the study and after signing an informed consent, they were referred to Blood Transfusion Center. With completion of laboratory tests, interviewers filled the questionnaires.Results. One hundred and eighteen (20.5%) and 107 (18.6%) family members were HBsAg and HBcAb positive respectively. 21 (3.6%) were isolated HBcAb positive. Only one person (1.3%) was HCVAb positive. The general rate of infection in family members of HBV infected people (atleast one case) (49.4%) was significantly higher than that of HCV infected people (3.3%), p < 0.001. Interspouses transmission was evaluated and prevalence of interspouses HBV and HCV infection were 32.3 and 8%, respectively.Conclusion. Intrafamilial and interspousal seropositivity of HBV is obviously more than those of HCV. More attention should be paid to screening and risk lowering activities particularly about HBV infected people and their families.

Primary risk factors of hepatitis C virus infection: a Meta-analysis

To provide evidence for decision-making on primary hepatitis C prevention through analyzing the main risk factors of hepatitis C virus infection. A comprehensive search was carried out in China Hospital Knowledge Database (CHKD), Wanfang Data, EBSCO, FMJS and Elsevier databases to identify all case-control and cohort studies published from 1994 to 2010 that evaluated the risk factors on the transmission of hepatitis C virus. Data manipulation and statistical analyses were performed using Stata 11.0 and RevMan 5.0 softwares. A total of 25 case-control studies were included in this Meta-analysis, which contained 4370 cases and 8606 controls. In univariate analysis, the pooled odds ratio (OR) and 95% confidence interval (CI) on the risk factors associated with HCV seropositivity were "blood transfusion" 4.23 (2.82 - 6.35), "having had surgical operations" 2.13 (1.70 - 2.67), "intravenous drug use" 52.28 (34.12 - 80.11), "having sex with intravenous drug users" 7.19 (3.13 - 16.51), "histories of having had STDs" 3.43 (2.70 - 4.34). In multivariate analysis, pooled OR and 95%CI of the risk factors associated with HCV seropositivity were:having had following "histories as blood transfusion" 6.03 (3.97 - 9.15), "surgeries" 2.10 (1.44 - 3.07), "intravenous drug use" 44.90 (31.13 - 64.76), "having sex with intravenous drug users"3.87 (2.07 - 7.24), "having STDs" 2.05 (1.19 - 3.52). Blood transfusion, intravenous drug use and having sex with intravenous drug users were the risk factors of HCV infection. Due to existing biases, the relationship between having had surgical operations and HCV infection was inconclusive. There appeared weak correlation between STDs and HCV infection, but the result was not so stability.

P1-S2.24 HIV and hepatitis C risk factors, infection status awareness and access to care among people who inject drugs - results from a national surveillance system, I-Track Phase 2 (2005–2008)

BackgroundHIV and hepatitis C (HCV) risk factors, infection status awareness and access to care among people who inject drugs (IDU) were compared across infection groups in a national enhanced surveillance...

259 HCV Seropositivity is Associated with Low Serum C-Reactive Protein (CRP) in Hemodialysis (HD)

259 HCV Seropositivity is Associated with Low Serum C-Reactive Protein (CRP) in Hemodialysis (HD)

Survival After Liver Transplantation Using Hepatitis C Virus‐Positive Donor Allografts: Case‐Controlled Analysis of the UNOS Database

Numerous reports have documented reduced graft and patient survival after use of hepatitis C (HCV) seropositive allografts in liver transplantation (OLT). We aimed to examine if the use of a HCV+ liver allograft affects patient and graft survivals compared to HCV- donor allografts in a case-controlled analysis of the united network for organ sharing (UNOS) database. We examined 63,149 liver transplants (61,905 donors HCV-; 1,244 donors HCV+) from the UNOS standard transplant analysis and research (STAR) file from 1987 to 2007. Donor and recipient demographics and outcomes were collected in which donor HCV serology was complete. A case-controlled cohort from 11 donor and recipient variables comparing donor HCV- and HCV+ allografts (n=540 in each group) was created using propensity scores with a matching algorithm. Graft and patient survival was estimated using Kaplan-Meier survival curves. Significant differences were evident in the unadjusted cohort between recipients who received HCV+ and HCV- allografts, including HCV+ recipients, donor and recipient age, and model for end-stage liver disease (MELD) exception cases. Use of HCV+ allograft resulted in significantly lower graft survival (8.1 vs. 10.6 years; P=0.001) and patient survival (10.2 vs. 12.3 years; P=0.01) after OLT. In the matched cohort, HCV seropositivity had no detrimental effect on the graft (P=0.57) or patient (P=0.78) survival after OLT. This is the first population-based analysis to show that after adjusting for donor and recipient characteristics there was no difference in graft or patient survival with the use of HCV+ donor liver allografts compared to HCV- donor liver allografts.

Characteristics of HIV-infected women and factors associated with HCV seropositivity in the Republic of Georgia

BackgroundThe aim of this study was to describe the extent of the HIV epidemic among women in the Republic of Georgia and to identify factors associated with HCV co-infection in this population.FindingsAll women aged ≥18 years who were diagnosed with HIV between 1989 and 2006 were identified through the National HIV/AIDS surveillance database. Medical records were reviewed for demographic characteristics, risk factors and HCV serostatus. A total of 249 women were identified. Only 4% declared injection drug use (IDU); sex work was reported by 9%. Substantial risk factors were identified among the women's sexual partners, nearly 69% of whom were IDUs, 84% were HIV positive and 66% HCV positive. Seventeen percent of women were seropositive for HCV. Factors significantly associated with HCV seropositivity in bivariate analyses among non-IDU women were partner IDU+ [Prevalence ratio (PR): 4.5 (95% CI: 1.4, 14.2)], and partner HCV+ [PR: 7.2 (95% CI: 1.8, 29.5)].ConclusionsThe HIV epidemic in the Republic of Georgia is closely tied to the IDU community. Evidence-based interventions targeting IDU and partners of IDU are urgently required to halt the spread of the HIV epidemic in the country.

Prevalence of the Blood-Borne Infections in Blood Donors – Our Experience in A Tertiary Teaching Hospital In North India.

Background: The infectious disease markers for which blood donors are screened include anti-human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), rapid plasma reagin (RPR) card test for syphilis and malarial parasites. Materials and Methods: A total of 3026 donors were screened over two years to assess the prevalence of infectious disease markers. Screening for anti-HIV I and II, HBsAg and anti-HCV was carried out by enzyme linked immunosorbent assay (ELISA). Syphilis was tested using RPR card test. Malaria parasite was tested by detection of genus specific Plasmodium lactate dehydrogenase. Result: The overall seropositivity for anti-HIV I and II was 3(0.1%), for HBsAg 55 (1.82%), for anti-HCV 25 (0.83%), for syphilis 4 (0.13%) and for malaria 6 (0.20%). There was a significant difference (p<.05) in the seropositivity of HBsAg between voluntary and replacement donors. A significant increase (p<.05) in the prevalence of seropositivity for HCV, but not for HIV and HBsAg and syphilis was found over the two year period of the study. Conclusion: The prevalence of infectious disease markers was similar to that reported by other studies in India. However, a significant difference was seen in the infectious marker positivity in voluntary and replacement donors, as no voluntary donor showed positivity for HIV, syphilis and malaria whereas only one voluntary donor for HBsAg and two voluntary donor for HCV infection was found positive in this period of study .

Age-specific frequency of screen-detected hepatitis C virus seropositivity in men from the Punjab province of Pakistan

Pakistan is a South Asian country with a high population seroprevalence of anti-hepatitis C virus (anti-HCV) antibody. In administrative districts of its most populous province, Punjab, the frequency of seropositivity for HCV in different age groups of adult men, the usual bread winners for their families, is not known. This study describes the frequency and age-distribution of seropositivity for anti-HCV antibodies in 58,680 clinically healthy, adult men, from nine districts of the Punjab province in Pakistan, undergoing pre-employment health screening. Laboratory records belonging to these men, screened by enzyme-linked immunosorbent assay 3 for antiHCV antibodies in serum, were analysed and frequencies were calculated. A total of 4034 (6.9%) were seropositive for HCV. The highest frequency of HCV seropositivity was noted in men from Multan (9.6%), followed by Lahore (9.4%) district. The lowest (5.0%) was noted among men residing in Bahawalpur district. There was a progressive increase in seroprevalence with increasing age in men from all districts. Further research needs to be initiated to describe differential HCV risk factor distribution in various districts and sustainability of relatively low seroprevalence noted in younger men.

HBV or HCV Coinfections and Risk of Myocardial Infarction in HIV-Infected Individuals: The D:A:D Cohort Study

Data on a link between HCV or HBV infection and the development of cardiovascular disease among HIV-negative and HIV-positive individuals are conflicting. We sought to investigate the association between HBV or HCV infection and myocardial infarction in HIV-infected individuals. The prospective observational database of the D:A:D collaboration of 11 cohorts of HIV-infected individuals, including 212 clinics in Europe, the United States and Australia was used. Multivariate Poisson regression was used to assess the effect of HCV or HBV infection on the development of myocardial infarction after adjustment for potential confounders, including cardiovascular risk factors, diabetes mellitus and exposure to antiretroviral therapy. Of 33,347 individuals, 517 developed a myocardial infarction over 157,912 person-years, with an event rate of 3.3 events/1,000 person-years (95% confidence interval [CI] 3.0-3.6). Event rates (95% CIs) per 1,000 person-years in those who were HCV-seronegative and HCV-seropositive were 3.3 (3.0-3.7) and 2.7 (2.2-3.3), respectively, and for those who were HBV-seronegative, had inactive infection or had active infection were 3.2 (2.8-3.5), 4.2 (3.1-5.2) and 2.8 (1.8-3.9), respectively. After adjustment, there was no association between HCV seropositivity (rate ratio 0.86 [95% CI 0.62-1.19]), inactive HBV infection (rate ratio 1.07 [95% CI 0.79-1.43]) or active HBV infection (rate ratio 0.78 [95% CI 0.52-1.15]) and the development of myocardial infarction. We found no association between HBV or HCV coinfection and the development of myocardial infarction among HIV-infected individuals.

Prevalence of hepatitis C, hepatitis B, and HIV infection among hemodialysis patients in Jenin District (Palestine)

Background and Aims: End-stage renal disease patients treated by hemodialysis (HD) are more susceptible for infection by viral hepatitis and human immunodeficiency virus (HIV) infections. Infection by these viruses is promoted by the characteristic immunological dysfunction that develops in renal failure and interferes with the patient's ability to eliminate these viruses. Prevalence of these viruses among hemodialysis patients in Jenin District (Palestine) was not studied until now, we aimed in this study to determine the prevalence of HCV, HBV and HIV among hemodialysis patients in Jenin District using serological methods, and to define the main risk factors for HCV infection. Materials and Methods: End-stage renal disease (ESRD) patients on maintenance hemodialysis from various demographic areas in Jenin District were included in the study. Data such as age, sex, drug abuse, history of transplantation were examined. Serological markers for HCV, HBV and HIV were determined using a microparticle enzyme immunoassay (MEIA). Pearson’ s correlation factor and independent samples t-test were used to analyze the significance of results. Results: The patients were 77 (42 males, 35 females, mean age 50.73 ± 16.78 years [age range: 14 – 80 years]), the mean duration of dialysis was 26.97 months with a standard deviation of 35.19 days. The prevalence of HCV was 24.68 % while the prevalence of HBsAg and HIV were 0% respectively. HCV seropositivity was associated with longer period of dialysis (P=0.000). There was no statistically significant correlation between age and HCV seropositivity (P=0.630), also there was no statistically significant relationship between sex and infection with HCV (P=0.849). Conclusion: The prevalence of HCV among hemodialysis patients in Jenin District is high compared to many Arab and other countries. None of the patients were a former drug abuser or had a history of tattooing. None of the patients was with a former transplant was HCV positive, so it seemed that the infection was mainly nosocomial during dialysis process. Duration of dialysis was an important risk factor (P=0.000). Dialysis staff, incomplete disinfection of dialysis machines (monitors), non-isolation of HCV positive patients on special dialysis units or special monitors may be important risk factors. So, careful attention of the preventive infection control measures is essential to limit the transmission of HCV in the dialysis unit in Jenin District.

Impact of residual renal function and HCV seropositivity on plasma CD40/CD40L system and oxidative status in haemodialysis patients

Objectives We evaluated the impact of residual renal function (RRF) on oxidative stress (SOX) and CD40/CD40L system in haemodialysis (HD) patients. Design and methods We determined sCD40, sCD40L and SOX marker—Cu/Zn superoxide dismutase (Cu/Zn SOD) levels in HD patients with RRF, with anuria (A) and in healthy controls. Results sCD40 and Cu/Zn SOD plasma levels were higher in both groups of dialyzed patients compared to controls (all p < 0.001), and they were higher in A than in RRF patients (all p < 0.01). In RRF group, sCD40/sCD40L and Cu/Zn SOD were significantly higher in anti-HCV-seropositive (anti-HCV[+]) patients than in their anti-HCV[−] counterparts. This phenomenon was not observed in A group. Multiple regression analysis showed that Cu/Zn SOD, kt/V and low fibrinogen were the independent factors affecting sCD40 levels in the whole HD group. Conclusions The loss of RRF and HCV seropositivity increased plasma levels of sCD40/sCD40L and oxidative status in HD patients.

Endothelial nitric oxide synthase gene intron 4 polymorphism predicts new onset diabetes mellitus after transplantation in kidney allograft recipients treated with cyclosporin A

Nitric oxide (NO), synthesized from LS: -arginine by the enzyme endothelial nitric oxide synthase (eNOS), is a potent vasodilator and has been implicated in mediating insulin-induced uptake and metabolism of glucose in skeletal muscle. Polymorphisms of the eNOS gene have been associated with altered eNOS activity and NO levels. Although several factors have been demonstrated for new onset diabetes mellitus after transplantation (NODAT), determining a genetic susceptibility for all patients requires further study. In our study, we evaluated the relationship between eNOS gene intron 4 polymorphism and NODAT in kidney allograft recipients. A total of 82 consecutive patients who received their first kidney transplantation and maintained graft function for at least a 12-month post-transplant period and who used triple therapy including cyclosporin A (CsA) for maintenance immunosuppression were included. PCR-RFLP was used for genetic analyses. Nine of 82 patients (11%) developed NODAT. Concerning the prevalence of eNOS intron 4 gene polymorphism, a significantly higher percentage of 4a allele carriers developed NODAT than non-carriers [6/26 (23.1%) versus 3/56 (5.4%), P = 0.02]. Compared with non-diabetics, NODAT patients were older (P = 0.04), had higher rate of hepatitis C (P < 0.05) and higher body mass index at the time of transplantation (P = 0.03). In regression analyses, having a 4a allele of the eNOS gene intron 4 polymorphism (P = 0.02) and HCV seropositivity (P = 0.03) were found to be independent risk factors for the development of NODAT. These findings suggest that carrying a 4a allele of the eNOS gene intron 4 polymorphism is associated with NODAT. This may help us to further understand the individual risk for development of NODAT in kidney allograft recipients under CsA treatment.

Availability of body art facilities and body art piercing do not predict hepatitis C acquisition among injection drug users in Montreal, Canada: Results from a cohort study

Background Cross-sectional associations suggest that body art piercing (BAP) is a risk factor for hepatitis C (HCV) infection among injection drug users. The temporal basis of the relationship has not been established. Methods Associations between HCV seropositivity, HCV incidence, recent BAP and BAP facility availability were evaluated among IDUs followed biannually between 2004 and 2008 in Montreal, Canada. A geographic information system was used to determine the availability of BAP facilities for each participant. Statistical models included individual and neighbourhood covariates. Logistic regression was used for analysis of HCV seropositivity. Cox proportional hazards regression was used for analysis of HCV incidence. Results Of 784 IDUs, 73% were seropositive for HCV. In multivariable logistic regression, HCV seropositivity was associated with BAP availability (OR: 1.32 95% confidence interval (CI): 1.1, 1.6) but not recent BAP. Of 145 initially HCV-negative participants, 52 seroconverted to HCV for an incidence of 27.7/100 person-years (95%CI: 20.9, 36.0). Crude hazard ratios (HR) for the association between HCV infection and BAP variables were: recent BAP, HR 0.98 (95%CI: 0.4, 2.7) and BAP facilities availability, HR 1.43 (95%CI: 1.1, 1.9). After accounting for individual and neighbourhood factors, crude associations between HCV infection and recent BAP and BAP facilities availability were: HR recent BAP, 0.96, 95%CI: 0.3, 2.7; and HR BAP facility availability, 1.21, 95%CI: 0.9, 1.7. Conclusion BAP facility availability is a marker of neighbourhood disadvantage associated with HCV seropositivity. Longitudinal analyses accounting for behaviour risk factors and neighbourhood characteristics do not support a temporal association between BAP acquisition, BAP facility availability, and HCV infection among IDUs.

Hepatitis C seropositivity is not a risk factor for sensory neuropathy among patients with HIV

Sensory neuropathy (SN) is common in patients with HIV. Hepatitis C (HCV) coinfection is often cited as an HIV-SN risk factor, but data to support this are lacking. This collaboration aimed to examine the association between HCV serostatus and SN risk among ambulatory HIV-positive patients. Patients with HIV were assessed in cross-sectional studies in Baltimore, Jakarta, Johannesburg, Kuala Lumpur, Melbourne, and Sydney for SN (defined by both supportive symptoms and signs). HCV seropositivity was assessed as an SN risk using a chi(2) test, followed by logistic regression modeling to correct for treatment exposures and demographics. A total of 837 patients of African, Asian, and Caucasian descent were studied. HCV seroprevalence varied by site (Baltimore n = 104, 61% HCV+; Jakarta 96, 51%; Johannesburg 300, 1%; Kuala Lumpur 97, 10%; Melbourne 206, 16%; Sydney 34, 18%). HCV seropositivity was not associated with increased SN risk at any site, but was associated with reduced SN risk in Melbourne (p = 0.003). On multivariate analyses, the independent associations with SN were increasing age, height, and stavudine exposure. HCV seropositivity was not independently associated with an increased SN risk at any site, but associated independently with reduced SN risk in Baltimore (p = 0.04) and Melbourne (p = 0.06). Hepatitis C (HCV) seropositivity was not associated with increased sensory neuropathy risk among HIV-positive patients at any site. While we were unable to assess HCV RNA or liver damage, the data suggest that HCV coinfection is not a major contributor to HIV-SN. HCV = hepatitis C; SN = sensory neuropathy.

CCL3L1Copy Number Is a Strong Genetic Determinant of HIV Seropositivity in Caucasian Intravenous Drug Users

A high copy number of CCL3L1, the most potent human immunodeficiency virus (HIV)-suppressive chemokine, associates with reduced HIV susceptibility. Whether CCL3L1 influences acquisition of multiple blood-borne infections (eg, hepatitis C virus [HCV], HIV, and hepatitis B virus [HBV] infections), which occur commonly among injection drug users (IDUs), is unknown. We determined CCL3L1 copy number by real-time polymerase chain reaction among 374 Caucasian IDUs from Estonia; 285 were HCV positive, 208 were HIV positive, 177 were HCV and HIV positive, and 57 were HCV and HIV negative. In univariate and multivariate analyses, HCV and HBV seropositivity and duration of IDU each strongly predicted HIV seropositivity. A high CCL3L1 copy number (>2) was associated with an 80% reduced risk of acquiring HIV infection after adjusting for age, sex, HCV and HBV status, CCR5-Delta32 polymorphism, and IDU duration (odds ratio, 0.20; 95% confidence interval, 0.09-0.45). By contrast, CCL3L1 gene dose did not influence HCV seropositivity. Among HCV-positive IDUs, there was a 3.5-fold overrepresentation and 65% underrepresentation of a high CCL3L1 copy number among HCV-positive, HIV-negative subjects and HCV-positive, HIV-positive subjects, respectively. Among IDUs with extensive exposure to HCV and HIV, CCL3L1 copy number is a major determinant of HIV seropositivity but not of HCV seropositivity. The contrasting distribution of a protective high CCL3L1 copy number among HCV-positive, HIV-negative IDUs versus HCV-positive, HIV-positive IDUs may reflect that HIV preferentially selects for subjects with a low CCL3L1 gene dose.