Awareness of hepatitis C infection among women with and at risk for HIV.
BACKGROUND
Treatment guidelines recommend all HIV/HCV-co-infected persons be considered for hepatitis C virus (HCV) treatment, yet obstacles to testing and accessing treatment for HCV continue for women.


OBJECTIVE
To assess awareness of HCV, and describe diagnostic referrals and HCV treatment among women in the Women's Interagency HIV Study (WIHS).


METHODS
Prospective epidemiologic cohort.


METHODS
Of 3,768 HIV-infected and uninfected women in WIHS, 1,166 (31%) were HCV antibody positive.


RESULTS
Awareness of HCV infection and probability of referrals for diagnostic evaluations and treatment using logistic regression. Follow-up HCV information was available for 681 (390 died, 15 withdrew, 80 missed visit) in 2004. Of these 681, 522 (76.7%) reported knowing their HCV diagnosis. Of these, 247 of 522 (47.3%) stated their providers recommended a liver biopsy, whereas 139 of 247 or 56.3% reported having a liver biopsy. A total of 170 of 522 (32.6%) reported being offered treatment and 74.1% (n = 126 of 170) reported receiving HCV treatment. In multivariate regression analyses, African-American race, Hispanic/Latina ethnicity, poverty, and current crack/cocaine/heroin use were negatively associated with treatment referrals, whereas elevated alanine aminotransferase (ALT) was associated with increased likelihood of referral and increased likelihood of treatment.


CONCLUSIONS
One quarter of women with HCV in this cohort were not aware of their diagnosis. Among those aware of their HCV, 1 in 4 received liver biopsy and treatment for HCV. Both provider and patient education interventions regarding HCV testing and HCV treatment options and guidelines are needed to enhance HCV awareness and participation in HCV evaluation and treatment.
Cohen
Mardge H
MH
CORE Center, Cook County Bureau of Health Services, Chicago, IL, USA. mardgecohen@aol.com
Grey
Dennis
D
Cook
Judith A
JA
Anastos
Kathryn
K
Seaberg
Eric
E
Augenbraun
Michael
M
Burian
Pam
P
Peters
Marion
M
Young
Mary
M
French
Audrey
A
D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000193:education / Q000523:psychology
D018937:Hepatitis C Antibodies