Effect of race and HIV co-infection upon treatment prescription for hepatitis C virus.
BACKGROUND
Treatment rates for hepatitis C virus (HCV) have not been compared directly between HCV mono-infected and HCV-HIV co-infected patients in academic center settings.


METHODS
We prospectively enrolled consecutive mono-infected and co-infected subjects at three academic centers in the USA. Clinical and laboratory data were gathered through interviews and medical records. Logistic regression analysis was used to determine the factors associated with treatment prescription for HCV.


RESULTS
The 241 HCV mono-infected and 158 HCV-HIV co-infected subjects were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the latter group. The co-infected subjects were less likely to have a liver biopsy (43.7% vs. 71.4%, p < 0.001) or ever receive treatment for HCV (32.3% vs. 62.2%, p < 0.001). In bivariate analysis, subjects not prescribed treatment for HCV were more likely to be black, have HIV co-infection, and have ongoing alcohol abuse. In multivariate analysis, black race (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.28-0.70) and HIV co-infection (OR 0.33, 95% CI 0.21-0.53) were independently associated with non-prescription of treatment.


CONCLUSIONS
Black race and HIV co-infection are associated with a lower likelihood of treatment for HCV. Addressing comorbidities in these populations may help to reduce such treatment disparities.
Butt
Adeel A
AA
Division of Infectious Diseases, 3601 Fifth Avenue, Suite 3A, Falk Medical Building, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. butta@dom.pitt.edu
Tsevat
Joel
J
Leonard
Anthony C
AC
Shaikh
Obaid S
OS
McMahon
Deborah
D
Khan
Uzma A
UA
Dorey-Stein
Zachariah
Z
Lo Re
Vincent
V
D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D000998:Antiviral Agents / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009820:Ohio / Q000453:epidemiology; D018579:Patient Selection; D010414:Pennsylvania / Q000453:epidemiology; D044469:Racial Groups; D001741:Black or African American
D000998:Antiviral Agents