Effect of race and HIV co-infection upon treatment prescription for hepatitis C virus

Int J Infect Dis. 2009 Jul;13(4):449-55. doi: 10.1016/j.ijid.2008.06.041. Epub 2008 Nov 6.

Abstract

Background: Treatment rates for hepatitis C virus (HCV) have not been compared directly between HCV mono-infected and HCV-HIV co-infected patients in academic center settings.

Methods: We prospectively enrolled consecutive mono-infected and co-infected subjects at three academic centers in the USA. Clinical and laboratory data were gathered through interviews and medical records. Logistic regression analysis was used to determine the factors associated with treatment prescription for HCV.

Results: The 241 HCV mono-infected and 158 HCV-HIV co-infected subjects were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the latter group. The co-infected subjects were less likely to have a liver biopsy (43.7% vs. 71.4%, p < 0.001) or ever receive treatment for HCV (32.3% vs. 62.2%, p < 0.001). In bivariate analysis, subjects not prescribed treatment for HCV were more likely to be black, have HIV co-infection, and have ongoing alcohol abuse. In multivariate analysis, black race (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.28-0.70) and HIV co-infection (OR 0.33, 95% CI 0.21-0.53) were independently associated with non-prescription of treatment.

Conclusions: Black race and HIV co-infection are associated with a lower likelihood of treatment for HCV. Addressing comorbidities in these populations may help to reduce such treatment disparities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Alcoholism / complications
  • Alcoholism / epidemiology
  • Antiviral Agents / therapeutic use
  • Black People / statistics & numerical data
  • Black or African American
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications*
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy*
  • Humans
  • Male
  • Odds Ratio
  • Ohio / epidemiology
  • Patient Selection
  • Pennsylvania / epidemiology
  • Racial Groups

Substances

  • Antiviral Agents