HIV Treatment can Facilitate Hepatitis C Care in Some Cases

Patients receiving care for HIV may be able to facilitate hepatitis C virus (HCV) co-infection treatment, according to a paper published in The Journal of Infection Diseases.

Investigators from around the U.S. constructed their own HIV treatment cascades with the intent to characterize the treatment and understand the barriers among men and women who are at risk for or who have HIV. These treatment cascades were developed using data from The Women’s Interagency HIV Study, which evaluated nearly 2500 women over 6 visits between 2015-2018, and the Multicenter AIDS Cohort Study, which examined about 2200 men during 1 visit between 2015-2018.

The study authors wrote that people with HIV more frequently have HCV co-infection compared to other groups, and furthermore, experience accelerated liver-related mortality. They explained that direct-acting antivirals (DAAs) can yield high sustained virologic response (SVR) rates; however, they described the uptake as suboptimal.

The study participants included 323 women and 93 men who were eligible for cascade treatment, meaning they were HCV RNA-positive or reported DAAs. The participants were surveyed and self-reported barriers in clinical terms, (like CD4 levels), patient barriers (such as missed visits), systemic barriers (such as appointment access), and financial and insurance barriers.

Most of the participants had HIV, with women at 77% and men at 70%. The investigators also noted that 69% and 63% of the women and men were Black, respectively, and found that the HIV-positive women were more likely to attain cascade outcomes when compared to HIV-negative women (39% vs. 23% initiated, respectively; and 21% vs. 12% SVR, respectively). Similar rates were found among the men they analyzed.

Black men and patients who were substance abuse users were treated less often, the study authors reported. They also found that women initiating treatment reported fewer patient barriers compared to women who did not initiate treatment (14% vs. 33%, respectively).

Clinical barriers were prevalent, at about 53%, among men who were not treated.

“HIV care may facilitate HCV treatment linkage and barrier navigation,” the study authors concluded. “HIV-negative individuals, Black men, and substance users may need additional support.”

As many as two-thirds of adults who should receive HIV testing have not received the testing at all, according to a study presented during the International AIDS Society AIDS 2020 Virtual Sessions and reported by HCPLive®. A third of survey responders lived in areas with a high HIV burden, while three-quarters had visited a primary care provider in the past year of their survey response – but not tested. The most commonly preferred testing method was through a routine visit to their health care provider (53%), according to the study, followed by self-testing for HIV (18%) and access via an urgent or walk-in clinic (12%).

A study presented at the American College of Gastroenterology 2020 conference also found that federally qualified health center are beneficial for patients who need to receive the full suite of HCV treatment, also reported by HCPLive.