HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014-2015

HIV Research Network

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Despite the high prevalence of hepatitis C virus (HCV) among persons living with HIV (PWH), the prevalence of HCV screening, treatment, and sustained virologic response (SVR) is unknown. This study aims to characterize the continuum of HCV screening and treatment among PWH in HIV care. SETTING: Adult patients enrolled at 12 sites of the HIV Research Network located in 3 regions of the United States were included. METHODS: We examined the prevalence of HCV screening, HCV coinfection, direct-acting antiretroviral (DAA) treatment, and SVR-12 between 2014 and 2015. Multivariate logistic regression was performed to identify characteristics associated with outcomes, adjusted for site. RESULTS: Among 29,071 PWH (age 18-87, 74.8% male, 44.4% black), 77.9% were screened for HCV antibodies; 94.6% of those screened had a confirmatory HCV RNA viral load test. Among those tested, 61.1% were determined to have chronic HCV. We estimate that only 23.4% of those eligible for DAA were prescribed DAA, and only 17.8% of those eligible evidenced initiating DAA treatment. Those who initiated treatment achieved SVR-12 at a rate of 95.2%. Blacks and people who inject drugs (PWID) were more likely to be screened for HCV than whites or those with heterosexual risk. Persons older than 40 years, whites, Hispanics, and PWID [adjusted odds ratio (AOR) 8.70 (7.74 to 9.78)] were more likely to be coinfected than their counterparts. When examining treatment with DAA, persons older than 50 years, on antiretroviral therapy [AOR 2.27 (1.11 to 4.64)], with HIV-1 RNA <400 [AOR 2.67 (1.71 to 4.18)], and those with higher Fib-4 scores were more likely to be treated with DAA. CONCLUSIONS: Although rates of screening for HCV among PWH are high, screening remains far from comprehensive. Rates of SVR were high, consistent with previously published literature. Additional programs to improve screening and make treatment more widely available will help reduce the impact of HCV morbidity among PWH.

Original languageEnglish (US)
Pages (from-to)559-567
Number of pages9
JournalJournal of acquired immune deficiency syndromes (1999)
Volume80
Issue number5
DOIs
StatePublished - Apr 15 2019

Fingerprint

Hepacivirus
HIV
Therapeutics
Odds Ratio
RNA
Hepatitis C Antibodies
Heterosexuality
Chronic Hepatitis C
Viral Load
Coinfection
Hispanic Americans
Pharmaceutical Preparations
HIV-1
Logistic Models
Morbidity
Sustained Virologic Response
Research

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014-2015. / HIV Research Network.

In: Journal of acquired immune deficiency syndromes (1999), Vol. 80, No. 5, 15.04.2019, p. 559-567.

Research output: Contribution to journalArticle

@article{8bf55b73e2af452d8f252aded9b976e8,
title = "HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014-2015",
abstract = "BACKGROUND: Despite the high prevalence of hepatitis C virus (HCV) among persons living with HIV (PWH), the prevalence of HCV screening, treatment, and sustained virologic response (SVR) is unknown. This study aims to characterize the continuum of HCV screening and treatment among PWH in HIV care. SETTING: Adult patients enrolled at 12 sites of the HIV Research Network located in 3 regions of the United States were included. METHODS: We examined the prevalence of HCV screening, HCV coinfection, direct-acting antiretroviral (DAA) treatment, and SVR-12 between 2014 and 2015. Multivariate logistic regression was performed to identify characteristics associated with outcomes, adjusted for site. RESULTS: Among 29,071 PWH (age 18-87, 74.8{\%} male, 44.4{\%} black), 77.9{\%} were screened for HCV antibodies; 94.6{\%} of those screened had a confirmatory HCV RNA viral load test. Among those tested, 61.1{\%} were determined to have chronic HCV. We estimate that only 23.4{\%} of those eligible for DAA were prescribed DAA, and only 17.8{\%} of those eligible evidenced initiating DAA treatment. Those who initiated treatment achieved SVR-12 at a rate of 95.2{\%}. Blacks and people who inject drugs (PWID) were more likely to be screened for HCV than whites or those with heterosexual risk. Persons older than 40 years, whites, Hispanics, and PWID [adjusted odds ratio (AOR) 8.70 (7.74 to 9.78)] were more likely to be coinfected than their counterparts. When examining treatment with DAA, persons older than 50 years, on antiretroviral therapy [AOR 2.27 (1.11 to 4.64)], with HIV-1 RNA <400 [AOR 2.67 (1.71 to 4.18)], and those with higher Fib-4 scores were more likely to be treated with DAA. CONCLUSIONS: Although rates of screening for HCV among PWH are high, screening remains far from comprehensive. Rates of SVR were high, consistent with previously published literature. Additional programs to improve screening and make treatment more widely available will help reduce the impact of HCV morbidity among PWH.",
author = "{HIV Research Network} and Daniel Radwan and Edward Cachay and Oluwaseun Falade-Nwulia and Moore, {Richard D} and Ryan Westergaard and Mathews, {William Christopher} and Judith Aberg and Laura Cheever and Kelly Gebo",
year = "2019",
month = "4",
day = "15",
doi = "10.1097/QAI.0000000000001949",
language = "English (US)",
volume = "80",
pages = "559--567",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014-2015

AU - HIV Research Network

AU - Radwan, Daniel

AU - Cachay, Edward

AU - Falade-Nwulia, Oluwaseun

AU - Moore, Richard D

AU - Westergaard, Ryan

AU - Mathews, William Christopher

AU - Aberg, Judith

AU - Cheever, Laura

AU - Gebo, Kelly

PY - 2019/4/15

Y1 - 2019/4/15

N2 - BACKGROUND: Despite the high prevalence of hepatitis C virus (HCV) among persons living with HIV (PWH), the prevalence of HCV screening, treatment, and sustained virologic response (SVR) is unknown. This study aims to characterize the continuum of HCV screening and treatment among PWH in HIV care. SETTING: Adult patients enrolled at 12 sites of the HIV Research Network located in 3 regions of the United States were included. METHODS: We examined the prevalence of HCV screening, HCV coinfection, direct-acting antiretroviral (DAA) treatment, and SVR-12 between 2014 and 2015. Multivariate logistic regression was performed to identify characteristics associated with outcomes, adjusted for site. RESULTS: Among 29,071 PWH (age 18-87, 74.8% male, 44.4% black), 77.9% were screened for HCV antibodies; 94.6% of those screened had a confirmatory HCV RNA viral load test. Among those tested, 61.1% were determined to have chronic HCV. We estimate that only 23.4% of those eligible for DAA were prescribed DAA, and only 17.8% of those eligible evidenced initiating DAA treatment. Those who initiated treatment achieved SVR-12 at a rate of 95.2%. Blacks and people who inject drugs (PWID) were more likely to be screened for HCV than whites or those with heterosexual risk. Persons older than 40 years, whites, Hispanics, and PWID [adjusted odds ratio (AOR) 8.70 (7.74 to 9.78)] were more likely to be coinfected than their counterparts. When examining treatment with DAA, persons older than 50 years, on antiretroviral therapy [AOR 2.27 (1.11 to 4.64)], with HIV-1 RNA <400 [AOR 2.67 (1.71 to 4.18)], and those with higher Fib-4 scores were more likely to be treated with DAA. CONCLUSIONS: Although rates of screening for HCV among PWH are high, screening remains far from comprehensive. Rates of SVR were high, consistent with previously published literature. Additional programs to improve screening and make treatment more widely available will help reduce the impact of HCV morbidity among PWH.

AB - BACKGROUND: Despite the high prevalence of hepatitis C virus (HCV) among persons living with HIV (PWH), the prevalence of HCV screening, treatment, and sustained virologic response (SVR) is unknown. This study aims to characterize the continuum of HCV screening and treatment among PWH in HIV care. SETTING: Adult patients enrolled at 12 sites of the HIV Research Network located in 3 regions of the United States were included. METHODS: We examined the prevalence of HCV screening, HCV coinfection, direct-acting antiretroviral (DAA) treatment, and SVR-12 between 2014 and 2015. Multivariate logistic regression was performed to identify characteristics associated with outcomes, adjusted for site. RESULTS: Among 29,071 PWH (age 18-87, 74.8% male, 44.4% black), 77.9% were screened for HCV antibodies; 94.6% of those screened had a confirmatory HCV RNA viral load test. Among those tested, 61.1% were determined to have chronic HCV. We estimate that only 23.4% of those eligible for DAA were prescribed DAA, and only 17.8% of those eligible evidenced initiating DAA treatment. Those who initiated treatment achieved SVR-12 at a rate of 95.2%. Blacks and people who inject drugs (PWID) were more likely to be screened for HCV than whites or those with heterosexual risk. Persons older than 40 years, whites, Hispanics, and PWID [adjusted odds ratio (AOR) 8.70 (7.74 to 9.78)] were more likely to be coinfected than their counterparts. When examining treatment with DAA, persons older than 50 years, on antiretroviral therapy [AOR 2.27 (1.11 to 4.64)], with HIV-1 RNA <400 [AOR 2.67 (1.71 to 4.18)], and those with higher Fib-4 scores were more likely to be treated with DAA. CONCLUSIONS: Although rates of screening for HCV among PWH are high, screening remains far from comprehensive. Rates of SVR were high, consistent with previously published literature. Additional programs to improve screening and make treatment more widely available will help reduce the impact of HCV morbidity among PWH.

UR - http://www.scopus.com/inward/record.url?scp=85062005639&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062005639&partnerID=8YFLogxK

U2 - 10.1097/QAI.0000000000001949

DO - 10.1097/QAI.0000000000001949

M3 - Article

C2 - 30649030

AN - SCOPUS:85062005639

VL - 80

SP - 559

EP - 567

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 5

ER -