Hepatitis C Elimination in People With HIV Is Contingent on Closing Gaps in the HIV Continuum.

Tytuł:: Hepatitis C Elimination in People With HIV Is Contingent on Closing Gaps in the HIV Continuum.
Autorzy:: Falade-Nwulia O; Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sutcliffe CG; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Mehta SH; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Moon J; Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Chander G; Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Keruly J; Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Katzianer J; Johns Hopkins Pharmaquip, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Thomas DL; Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Moore RD; Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sulkowski MS; Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Źródło:: Open forum infectious diseases [Open Forum Infect Dis] 2019 Sep 30; Vol. 6 (10), pp. ofz426. Date of Electronic Publication: 2019 Sep 30 (Print Publication: 2019).
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]-
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Grant Information:: K23 DA041294 United States DA NIDA NIH HHS; K24 AA027483 United States AA NIAAA NIH HHS; P30 AI094189 United States AI NIAID NIH HHS
Contributed Indexing:: Keywords: HIV; care continuum; hepatitis C; treatment
Entry Date(s):: Date Created: 20191101 Latest Revision: 20231228
Update Code:: 20231228
PubMed Central ID:: PMC6814283
DOI:: 10.1093/ofid/ofz426
PMID:: 31667200
: Czasopismo naukowe

Pełny tekst

Background: Bolstered by the high efficacy of hepatitis C virus (HCV) treatment, the World Health Organization has called for HCV elimination by 2030. People with HIV (PWH) have been identified as a population in which elimination should be prioritized.
Methods: We examined progress in HCV elimination through the HCV care continuum among patients infected with HIV/HCV receiving HIV care at Johns Hopkins Hospital in Baltimore, Maryland, United States. Patients with HIV care visits in at least 2 consecutive years were followed through December 15, 2018, for referral to HCV care, treatment initiation, and cure.
Results: Among 593 HIV/HCV-coinfected individuals, 547 (92%) were referred for HCV care, 517 (87%) were evaluated for HCV treatment, 457 (77%) were prescribed HCV treatment, 426 (72%) initiated treatment, and 370 (62%) achieved HCV cure. In multivariable analysis, advanced liver disease (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.17-1.88) remained significantly positively associated with HCV treatment initiation. Conversely, being insured by state Medicaid (HR, 0.75; 95% CI, 0.61-0.92), having an HIV RNA >400 copies/mL (HR, 0.29; 95% CI, 0.18-0.49), and having missed 1%-24% (HR, 0.72; 95% CI, 0.54-0.97), 25%-49% (HR, 0.66; 95% CI, 0.49-0.89), and ≥50% of HIV care visits (HR, 0.39; 95% CI, 0.25-0.60) were significantly negatively associated with HCV treatment initiation.
Conclusions: HCV infection can be eliminated in PWH. However, HCV elimination requires unrestricted access to HCV treatment and improved methods of retaining people in medical care.
(© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

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