title: High uptake of hepatitis C virus treatment in HIV/hepatitis C virus co-infected patients attending an integrated HIV/hepatitis C virus clinic.
abstract: Hepatitis C virus (HCV) is a major cause of liver disease in HIV-infected patients. The HCV treatment outcomes and barriers to HCV referral were examined in a centre with a HIV/HCV co-infection clinic. Patients who were antibody positive for both HIV and HCV between 1987 and January 2009 were identified. A retrospective chart review was undertaken. Multivariate analysis was performed to assess predictors of HCV clinic referral. Data were collected on 386 HIV/HCV patients; 202/386 had been referred to the co-infection clinic and 107/202 had HCV treatment. In addition, 29/202 were undergoing pretreatment work-up. Overall sustained virologic response (SVR) was 44%; SVR was equivalent in those who acquired HIV/HCV infection from intravenous drug use (IDU) and others. On multivariate analysis, patients who missed appointments, were younger, with active IDU and advanced HIV and who were not offered HCV treatment were less likely to be referred to the clinic. Patients attending the clinic were more likely to have been screened for hepatocellular carcinoma than those attending the general HIV service. Two-thirds of patients referred to the clinic had engaged with the HCV treatment programme. Dedicated co-infection clinics lower the threshold for treatment and improve management of liver disease in co-infected patients.
authors: Department of Genito-Urinary Medicine and Infectious Diseases, Dublin, Ireland. kieranja@tcd.ie
authors: J
authors: J
authors: Kieran
authors: A
authors: A
authors: Dillon
authors: G
authors: G
authors: Farrell
authors: A
authors: A
authors: Jackson
authors: S
authors: S
authors: Norris
authors: F
authors: F
authors: Mulcahy
authors: C
authors: C
authors: Bergin
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D060085:Coinfection; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D015397:Program Evaluation; D011994:Recombinant Proteins / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012254:Ribavirin / Q000627:therapeutic use*; D015819:Substance Abuse, Intravenous / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a