title: HIV, hepatitis C and HIV/hepatitis C virus co-infection in vulnerable populations.
abstract: OBJECTIVE
  To describe basic patient demographic and clinical characteristics of HIV-infected and HIV/hepatitis C virus (HCV)-co-infected patients receiving care in the Department of Veterans Affairs (VA) with a focus on some patient factors that place such patients at an increased risk of poor health outcomes.
  
  
  METHODS
  An observational retrospective cohort study.
  
  
  METHODS
  The study cohort consisted of veterans in the VA Immunology Case Registry who received care in the VA in 2002.
  
  
  RESULTS
  Of 18,349 HIV-infected patients, 6782 (37.0%) were HCV seropositive. Compared with HIV-alone-infected patients, HIV/HCV-co-infected patients were older, more likely to be men, more likely to be black or Hispanic, and more likely to report intravenous drug use as a risk factor for HIV acquisition. HIV/HCV-co-infected patients were more likely to have diagnoses of mental health illness, depression, alcohol abuse, substance abuse and hard drug abuse compared with HIV-alone-infected patients. Co-infected patients were less likely to have a history of an AIDS opportunistic infection ever and were less likely to have received HIV antiretroviral drugs in 2002.
  
  
  CONCLUSIONS
  The VA's HIV and HIV/HCV-co-infected patient populations have very high rates of additional comorbid conditions that complicate both the pharmacological therapy and clinical course of both HIV and HCV infections. Given the overlap in viral illness and comorbidities, optimal models of integrated care need to be developed for populations with HIV, HCV, and HIV/HCV co-infection and who need substance abuse treatment or mental healthcare.
authors.affiliation: Center for Quality Management in Public Health, US Department of Veterans Affairs, Palo Alto, CA, USA.
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Backus
authors.forename: Derek
authors.initials: D
authors.lastname: Boothroyd
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Deyton
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006526:Hepatitis C / Q000453:epidemiology* / Q000523:psychology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000821:virology; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans; D035862:Vulnerable Populations / Q000523:psychology