Journal
HIV CLINICAL TRIALS
Volume 10, Issue 1, Pages 25-32Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1310/hct1001-25
Keywords
coinfection; comorbidities; contraindications; HCV; HIV; treatment eligibility
Categories
Funding
- National Institutes of Health/National Institute on Drug Abuse [DA016175-01A1]
- National Institute for Allergy and Infectious Diseases [K01 AI070001-A1]
- National Center for Complementary and Alternative Medicine award [K24 AT001676]
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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.
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