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Cachay ER, Hill L, Ballard C, et al. Increasing Hepatitis C treatment uptake among HIV-infected patients using an HIV primary care model. AIDS Res Ther. 2013;10(1):9doi: 10.1186/1742-6405-10-9.
Cachay, E. R., Hill, L., Ballard, C., Colwell, B., Torriani, F., Wyles, D., & Mathews, W. C. (2013). Increasing Hepatitis C treatment uptake among HIV-infected patients using an HIV primary care model. AIDS research and therapy, 10(1), 9. https://doi.org/10.1186/1742-6405-10-9
Cachay, Edward R, et al. "Increasing Hepatitis C treatment uptake among HIV-infected patients using an HIV primary care model." AIDS research and therapy vol. 10,1 (2013): 9. doi: https://doi.org/10.1186/1742-6405-10-9
Cachay ER, Hill L, Ballard C, Colwell B, Torriani F, Wyles D, Mathews WC. Increasing Hepatitis C treatment uptake among HIV-infected patients using an HIV primary care model. AIDS Res Ther. 2013 Mar 28;10(1):9. doi: 10.1186/1742-6405-10-9. PMID: 23537147; PMCID: PMC3620560.
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AIDS Res Ther. 2013 Mar 28;10(1):9. doi: 10.1186/1742-6405-10-9.

Increasing Hepatitis C treatment uptake among HIV-infected patients using an HIV primary care model.

AIDS research and therapy

Edward R Cachay, Lucas Hill, Craig Ballard, Bradford Colwell, Francesca Torriani, David Wyles, William C Mathews

Affiliations

  1. Department of Medicine, Owen Clinic, University of California at San Diego, 200 W, Arbor Drive, San Diego, CA, 92103-8681, USA. [email protected].

PMID: 23537147 PMCID: PMC3620560 DOI: 10.1186/1742-6405-10-9

Abstract

BACKGROUND: Access to Hepatitis C (HCV) care is low among HIV-infected individuals, highlighting the need for new models to deliver care for this population.

METHODS: Retrospective cohort analysis that compared the number of HIV patients who initiated HCV therapy: hepatology (2005-2008) vs. HIV primary care model (2008-2011). Logistic-regression modeling was used to ascertain factors associated with HCV therapy initiation and achievement of sustained viral response (SVR).

RESULTS: Of 196 and 163 patients that were enrolled in the HIV primary care and hepatology models, 48 and 26 were treated for HCV, respectively (p = 0.043). The HIV/HCV-patient referral rate did not differ during the two study periods (0.10 vs. 0.12/patient-yr, p = 0.18). In unadjusted analysis, predictors (p < 0.05) of HCV treatment initiation included referral to the HIV primary care model (OR: 1.7), a CD4+ count ≥400/mm3 (OR: 1.8) and alanine aminotranferase level ≥63U/L (OR: 1.9). Prior psychiatric medication use correlated negatively with HCV treatment initiation (OR: 0.6, p = 0.045). In adjusted analysis the strongest predictor of HCV treatment initiation was CD4+ count (≥400/mm3, OR: 2.1, p = 0.01). There was no significant difference in either clinic model (primary care vs. hepatology) in the rates of treatment discontinuation due to adverse events (29% vs. 16%), loss to follow-up (8 vs. 8%), or HCV SVR (44 vs. 35%).

CONCLUSIONS: Using a HIV primary care model increased the number of HIV patients who initiate HCV therapy with comparable outcomes to a hepatology model.

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