Hepatitis C treatment eligibility among HIV-hepatitis C virus coinfected patients in Oregon: A population-based sample

Marissa M. Maier, Haiou He, Sean D. Schafer, Thomas Ward, Atif Zaman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Approximately 287,000 individuals in the USA are coinfected with HIV and hepatitis C. Recently, new hepatitis C regimens have become available, increasing rates of sustained virologic response in the monoinfected, with studies evaluating their success in the coinfected under way. Previous investigators estimated eligibility for hepatitis C therapy among the coinfected patients, but all had significant methodological limitations. Our study is the first to use a multi-year, statewide, population-based sample to estimate treatment eligibility, and the first to estimate eligibility in the setting of an interferon-free regimen. In a population-based sample of 161 patients infected with HIV and hepatitis C living in Oregon during 2007-2010, 21% were eligible for hepatitis C therapy. Despite the anticipation surrounding an interferon-sparing regimen, eligibility assuming an interferon-free regimen increased only to 26%, largely due to multiple simultaneous contraindications. Obesity was described for the first time as being associated with decreased eligibility (OR: 0.11). Active alcohol abuse was the most common contraindication (24%); uncontrolled mental health (22%), recent injection drug use (21%), poor antiretroviral adherence (22%), and infection (21%) were also common excluding conditions. When active drug or alcohol abuse was excluded as contraindications to therapy, the eligibility rate was 34%, a 62% increase. Assuming an interferon-free regimen and the exclusion of active drug or alcohol abuse as contraindications to therapy, the eligibility rate increased to 42%. Despite the availability of direct-acting anti-viral regimens, eligibility rates in HIV-hepatitis C virus (HCV) coinfection are modest. Many factors precluding hepatitis C therapy are reversible, and targeted interventions could result in increased eligibility.

Original languageEnglish (US)
Pages (from-to)1178-1185
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume26
Issue number9
DOIs
StatePublished - Sep 2 2014

Fingerprint

Hepatitis C
Hepacivirus
contagious disease
HIV
Interferons
Population
Alcoholism
abuse
alcohol
Substance-Related Disorders
Therapeutics
drug
Coinfection
Mental Health
Obesity
drug use
Research Personnel
exclusion
mental health
Injections

Keywords

  • coinfection
  • eligibility
  • hepatitis C
  • HIV
  • treatment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Social Psychology

Cite this

Hepatitis C treatment eligibility among HIV-hepatitis C virus coinfected patients in Oregon : A population-based sample. / Maier, Marissa M.; He, Haiou; Schafer, Sean D.; Ward, Thomas; Zaman, Atif.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 26, No. 9, 02.09.2014, p. 1178-1185.

Research output: Contribution to journalArticle

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