Hepatitis C coinfection is independently associated with decreased adherence to antiretroviral therapy in a population-based HIV cohort

Paula Braitstein, Amy Justice, David R. Bangsberg, Benita Yip, Victoria Alfonso, Martin T. Schechter, Robert S. Hogg, Julio S.G. Montaner

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Objective: To characterize the impact of hepatitis C (HCV) serostatus on adherence to antiretroviral treatment (ART) among HIV-infected adults initiating ART. Methods: The British Columbia HIV/AIDS Drug Treatment Program distributes, at no cost, all ART in this Canadian province. Eligible individuals used triple combination ART as their first HIV therapy and had documented HCV serology. Statistical analyses used parametric and non-parametric methods, including multivariate logistic regression. The primary outcome was ≥ 95% adherence, defined as receiving ≥ 95% of prescription refills during the first year of antiretroviral therapy. Results: There were 1186 patients eligible for analysis, including 606 (51%) positive for HCV antibody and 580 (49%) who were negative. In adjusted analyses, adherence was independently associated with HCV seropositivity [adjusted odds ratio (AOR), 0.48; 95% confidence interval (CI), 0.23-0.97; P = 0.003], higher plasma albumin levels (AOR, 1.07; 95% CI, 1.01-1.12; P = 0.002) and male gender (AOR, 2.53; 95% CI, 1.04-6.15; P = 0.017), but not with injection drug use (IDU), age or other markers of liver injury. There was no evidence of an interaction between HCV and liver injury in adjusted analyses; comparing different strata of HCV and IDU confirmed that HCV was associated with poor adherence independent of IDU. Conclusions: HCV-coinfected individuals and those with lower albumin are less likely to be adherent to their ART.

Original languageEnglish (US)
Pages (from-to)323-331
Number of pages9
JournalAIDS
Volume20
Issue number3
DOIs
StatePublished - Feb 2006

Keywords

  • Adherence
  • Antiretroviral therapy
  • HIV
  • Hepatitis C
  • Injection drug use
  • Tolerability
  • Toxicity
  • Transaminitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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