Barriers and Facilitators of Hepatitis C Care in Persons Coinfected with Human Immunodeficiency Virus

Nir Bar, Noa Bensoussan, Liane Rabinowich, Sharon Levi, Inbal Houri, Dana Ben-Ami Shor, Oren Shibolet, Orna Mor, Ella Weitzman, Dan Turner and Helena Katchman ()
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Nir Bar: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Noa Bensoussan: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Liane Rabinowich: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Sharon Levi: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Inbal Houri: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Dana Ben-Ami Shor: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Oren Shibolet: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
Orna Mor: Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel
Ella Weitzman: Center for Liver Disease, Rambam Healthcare Campus, Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel
Dan Turner: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6195001, Israel
Helena Katchman: Gastroenterology and Hepatology Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel

IJERPH, 2022, vol. 19, issue 22, 1-10

Abstract: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are often co-transmitted. Viral coinfection results in worse outcomes. Persons who inject drugs (PWIDs) face barriers to medical treatment, but HCV treatment is indicated and effective even with ongoing active drug use. We aimed to assess access to HCV care and treatment results in patients coinfected with HIV-HCV. This is a real-world retrospective single-center study of patients followed in the HIV clinic between 2002 and 2018. Linkage to care was defined as achieving care cascade steps: (1) hepatology clinic visit, (2) receiving prescription of anti-HCV treatment, and (3) documentation of sustained virologic response (SVR). Of 1660 patients with HIV, 254 with HIV-HCV coinfection were included. Only 39% of them achieved SVR. The rate limiting step was the engagement into hepatology care. Being a PWID was associated with ~50% reduced odds of achieving study outcomes, active drug use was associated with ~90% reduced odds. Older age was found to facilitate treatment success. Once treated, the rate of SVR was high in all populations. HCV is undertreated in coinfected young PWIDs. Further efforts should be directed to improve access to care in this marginalized population.

Keywords: low-barrier treatment; hepatitis C infection; human immunodeficiency virus; coinfection; persons who inject drugs; barriers to care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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