Rates of HCV treatment eligibility among HCV-monoinfected and HCV/HIV-coinfected patients in tertiary care referral centers

HIV Clin Trials. 2009 Jan-Feb;10(1):25-32. doi: 10.1310/hct1001-025.

Abstract

Background: Treatment eligibility rates in patients with HCV monoinfection have not been directly compared with patients with HCV/HIV coinfection. These data are important for planning interventions to optimize HCV management.

Method: We enrolled consecutive HCV-monoinfected and HCV/HIV-coinfected subjects presenting to hepatology and HIV clinics at three academic medical centers. Data were obtained through structured subject and provider interviews and a review of medical records.

Results: Of the 399 subjects enrolled, 241 (60%) were HCV monoinfected and 158 (40%) were HCV/HIV coinfected. HCV/HIV-coinfected subjects were less likely to have indications for treatment based on HCV RNA positivity (70.9% vs. 81.3%, p = .04) but were more likely to have at least one contraindication to treatment (81.6% vs. 64.9%, p < .004). Depression and ongoing alcohol and injection drug abuse were more common in the HCV/HIV-coinfected persons. HCV/HIV-coinfected persons were less likely to undergo liver biopsy or to ever get treatment for HCV.

Conclusions: HCV/HIV-coinfected persons are less likely to undergo a liver biopsy or be eligible for HCV therapy and are more likely to have treatment contraindications compared with HCV-monoinfected subjects. Strategies to address modifiable factors (e.g., depression, substance abuse) may enhance treatment eligibility in HCV-infected populations.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • Antiviral Agents* / therapeutic use
  • Contraindications
  • Eligibility Determination / statistics & numerical data*
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • Health Personnel
  • Hepacivirus / genetics
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy*
  • Humans
  • Interviews as Topic
  • Male
  • Medical Records
  • Middle Aged
  • RNA, Viral / blood
  • United States

Substances

  • Anti-HIV Agents
  • Antiviral Agents
  • RNA, Viral