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- Title
Disparities in Treatment with Direct-Acting Hepatitis C Virus Antivirals Persist Among Adults Coinfected with HIV and Hepatitis C Virus in US Clinics, 2010–2018.
- Authors
Simoncini, Gina M.; Hou, Qingjiang; Carlson, Kimberly; Buchacz, Kate; Tedaldi, Ellen; Palella Jr., Frank; Durham, Marcus; Li, Jun; Durham, Marcus D.; Akridge, Cheryl; Purinton, Stacey; Agbobil-Nuwoaty, Selom; Chagaris, Kalliope; Armon, Carl; Battalora, Linda; Palella, Frank J.; Jahangir, Saira; Flaherty, Conor Daniel; Greenberg, Kenneth S.; Widick, Barbara
- Abstract
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection carries substantial risk for all-cause mortality and liver-related morbidity and mortality, yet many persons coinfected with HIV/HCV remain untreated for HCV. We explored demographic, clinical, and sociodemographic factors among participants in routine HIV care associated with prescription of direct-acting antivirals (DAAs). The HIV Outpatient Study (HOPS) is an ongoing longitudinal cohort study of persons with HIV in care at participating clinics since 1993. There are currently eight study sites in six US cities. We analyzed medical records data of HOPS participants diagnosed with HCV since June 2010. Sustained virological response (SVR) was documented with first undetectable HCV viral load (VL). We assessed factors associated with being prescribed DAAs by multi-variable logistic regression and described the cumulative rate of SVR. Among 306 eligible participants, 131 (43%) were prescribed DAA therapy. Factors associated with greater odds of being prescribed DAA were older age, private health insurance, higher CD4 cell count, being a person who injects drugs, and receiving care at publicly funded sites (p < 0.05). Of 127 (97%) participants with at least 1 follow-up HCV VL, 110 (87%) achieved SVR at 12 weeks. Of the total 131 participants, 123 (94%) eventually achieved SVR. Less than half of HIV/HCV coinfected patients in HOPS have been prescribed DAAs. Interventions are needed to address deficits in DAA prescription, including among patients with public or no health insurance, younger age, and lower CD4 cell count.
- Subjects
UNITED States; HIV infections; HIV-positive persons; HEALTH services accessibility; ACQUISITION of data methodology; VIRAL load; AGE distribution; ANTIVIRAL agents; HEPATITIS C; HEALTH status indicators; SOCIOECONOMIC factors; TREATMENT effectiveness; MIXED infections; MEDICAL records; DRUG prescribing; HEALTH insurance; DESCRIPTIVE statistics; LOGISTIC regression analysis; PHYSICIAN practice patterns; OUTPATIENT services in hospitals; LONGITUDINAL method
- Publication
AIDS Patient Care & STDs, 2021, Vol 35, Issue 10, p392
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2021.0087