2359. Evaluating Hepatitis C Virus (HCV) Diagnostic Testing, Cure and Reinfection among People Living with HCV and HIV Coinfection in New York City

Abstract Background Untreated hepatitis C virus (HCV) infection can lead to liver disease, cancer and premature death; HIV coinfection can accelerate adverse outcomes. People living with HIV (PLWH) should be screened for HCV with an antibody test at least once and more frequently if other risk factors. A diagnostic HCV RNA test should be used to determine cure/clearance (RNA-negative) vs active infection (RNA-positive). Among people with HCV/HIV coinfection in New York City (NYC), we aimed to 1) describe HCV testing, cure/clearance, reinfection and identify disparities; 2) assess relative timing of HCV/HIV coinfection diagnosis to evaluate HCV testing among PLWH. Methods PLWH as of September 30, 2021 were matched to people with a positive HCV test July 1, 2014–December 31, 2020; HCV test results through December 31, 2021 were used for analyses and to observe cure. A HCV clearance cascade was created to evaluate testing, cure/clearance and reinfection, and was stratified by age, sex and race/ethnicity. Timing of coinfection was assessed for people with new HCV/HIV diagnoses January 1, 2014–December 31, 2020 to identify recent trends. Coinfection date was defined as the later HCV or HIV diagnosis date. Results There were 11,137 PLWH with any positive HCV test. Of these, 10,773 (97%) had an RNA test; 8,926 (83%) had initial active infection; 6,901 (77%) had cure/clearance and 302 (4%) with cure/clearance were reinfected (Figure 1). Black Non-Hispanic (NH) people and those aged 20–39 had a high burden of active infection, with 3,653 (87%) and 803 (93%), respectively. Both groups had proportionally lower cure/clearance (77% and 63%, respectively) compared to Asian NH people (86%) and people ≥ 60 (81%) having the highest proportions. Most people with recent coinfections were diagnosed with HIV prior to HCV (annual range: 39%–71%) (Figure 2). Conclusion HCV diagnostic testing and cure/clearance were high and reinfection was low among people with coinfection in NYC. Most people with coinfection had HCV RNA tests, indicating appropriate HCV testing in this population. Cure/clearance could be improved among younger and Black NH people; provider and patient education might improve outcomes. To initiate timely treatment, providers should continue screening PLWH for HCV as HIV infection often precedes HCV infection. Disclosures All Authors: No reported disclosures.