title: Positive impact of hepatitis C virus (HCV) treatment on antiretroviral treatment adherence in human immunodeficiency virus-HCV coinfected patients: one more argument for expanded access to HCV treatment for injecting drug users.
abstract: OBJECTIVE
  Treatment for the hepatitis C virus (HCV) may be delayed significantly in human immunodeficiency virus (HIV)/HCV coinfected patients on antiretroviral treatment (ART) for fear that its burden could compromise ART adherence. However, the effect such treatment has on ART adherence in observational settings remains largely unknown. Longitudinal data were used to investigate the relationship between initiating HCV treatment and adherence to ART in HIV/HCV coinfected patients.
  
  
  METHODS
  The French national prospective cohort of patients coinfected with HIV and HCV (ANRS-CO-13-HEPAVIH) is a multi-centre cohort.
  
  
  METHODS
  Seventeen out-patient hospital services delivering HIV and HCV care in France.
  
  
  METHODS
  HIV/HCV coinfected patients on ART (n = 593 patients, 976 visits).
  
  
  METHODS
  Self-administered questionnaires and medical records. A mixed logistic regression model based on generalized estimates equations (GEE) to identify factors associated with non-adherence to ART.
  
  
  RESULTS
  Among the 593 patients, 36% were classified as non-adherent to ART at the enrolment visit and 12% started HCV treatment during follow-up. ART adherence was not associated statistically with HCV treatment initiation. The proportion of patients maintaining adherence or becoming adherent to ART for those starting HCV treatment was higher than in the rest of the sample (P = 0.07). After multiple adjustment for known correlates, such as poor housing conditions, binge drinking, recent drug use and depressive symptoms, patients who initiated HCV treatment were less likely to be non-adherent to ART [odds ratio (95% confidence interval) = 0.41 (0.24-0.71)].
  
  
  CONCLUSIONS
  Engaging human immunodeficiency virus/hepatitis C virus coinfected individuals in hepatitis C virus treatment is associated with high adherence to antiretroviral treatment. Physicians should prioritize hepatitis C virus treatment as part of a multi-disciplinary approach.
authors.affiliation: INSERM, U912, SE4S, Marseille, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.forename: Lionel
authors.initials: L
authors.lastname: Fugon
authors.forename: Maria
authors.initials: M
authors.lastname: Winnock
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon-Céron
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection; D003863:Depression / Q000150:complications; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000506:poisoning; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents; D000998:Antiviral Agents; D016898:Interferon-alpha; D000431:Ethanol; D012254:Ribavirin