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, Helena Katchman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number15237
JournalInternational Journal of Environmental Research and Public Health
Volume19
Issue number22
DOIs
StatePublished - Nov 2022

Keywords

  • barriers to care
  • coinfection
  • hepatitis C infection
  • human immunodeficiency virus
  • low-barrier treatment
  • persons who inject drugs

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