Hepatitis C treatment eligibility among HIV–hepatitis C virus coinfected patients in Oregon: a population-based sample.

Approximately 287,000 individuals in the USA are coinfected with HIV and hepatitis C. Recently, new hepatitis C regimens have become available, increasing rates of sustained virologic response in the monoinfected, with studies evaluating their success in the coinfected under way. Previous investigat...

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Publicado en:AIDS Care Vol. 26; no. 9; pp. 1178 - 1186
Autores principales: Maier, Marissa M., He, Haiou, Schafer, Sean D., Ward, Thomas T., Zaman, Atif
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Sep2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2014
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      pub: Taylor & Francis Ltd
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        10.1080/09540121.2014.892563
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        atl: Hepatitis C treatment eligibility among HIV–hepatitis C virus coinfected patients in Oregon: a population-based sample.
      aug:
        au:
          Maier, Marissa M.
          He, Haiou
          Schafer, Sean D.
          Ward, Thomas T.
          Zaman, Atif
        affil: Division of Infectious Diseases, Oregon Health and Sciences University, Portland, OR, USA
      sug:
        subj:
          HIV Infections Physiopathology
          Hepatitis C Therapy
          Patient Selection
          Comorbidity
          Oregon
          Disease Surveillance
          Demography
          Retrospective Design
          Cross Sectional Studies
          Random Sample
          Descriptive Statistics
          Confidence Intervals
          Multiple Logistic Regression
          P-Value
          Chi Square Test
          Data Analysis Software
          Odds Ratio
          Adult
          Middle Age
          Aged
          Female
          Male
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Approximately 287,000 individuals in the USA are coinfected with HIV and hepatitis C. Recently, new hepatitis C regimens have become available, increasing rates of sustained virologic response in the monoinfected, with studies evaluating their success in the coinfected under way. Previous investigators estimated eligibility for hepatitis C therapy among the coinfected patients, but all had significant methodological limitations. Our study is the first to use a multi-year, statewide, population-based sample to estimate treatment eligibility, and the first to estimate eligibility in the setting of an interferon-free regimen. In a population-based sample of 161 patients infected with HIV and hepatitis C living in Oregon during 2007–2010, 21% were eligible for hepatitis C therapy. Despite the anticipation surrounding an interferon-sparing regimen, eligibility assuming an interferon-free regimen increased only to 26%, largely due to multiple simultaneous contraindications. Obesity was described for the first time as being associated with decreased eligibility (OR: 0.11). Active alcohol abuse was the most common contraindication (24%); uncontrolled mental health (22%), recent injection drug use (21%), poor antiretroviral adherence (22%), and infection (21%) were also common excluding conditions. When active drug or alcohol abuse was excluded as contraindications to therapy, the eligibility rate was 34%, a 62% increase. Assuming an interferon-free regimenandthe exclusion of active drug or alcohol abuse as contraindications to therapy, the eligibility rate increased to 42%. Despite the availability of direct-acting anti-viral regimens, eligibility rates in HIV–hepatitis C virus (HCV) coinfection are modest. Many factors precluding hepatitis C therapy are reversible, and targeted interventions could result in increased eligibility.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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