Effect of race and HIV co-infection upon treatment prescription for hepatitis C virus

• Published in: International journal of infectious diseases Vol. 13; no. 4; pp. 449 - 455
• Main Authors: Butt, Adeel A, Tsevat, Joel, Leonard, Anthony C, Shaikh, Obaid S, McMahon, Deborah, Khan, Uzma A, Dorey-Stein, Zachariah, Re, Vincent Lo
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.07.2009; Elsevier
• Subjects: Alcoholism - complications; Alcoholism - epidemiology; Antiviral Agents - therapeutic use; Biological and medical sciences; Black or African American; Black People - statistics & numerical data; Co-infection; Cross-Sectional Studies; Female; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C virus; HIV; HIV Infections - complications; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious Disease; Infectious diseases; Male; Medical sciences; Odds Ratio; Ohio - epidemiology; Patient Selection; Pennsylvania - epidemiology; Pulmonary/Respiratory; Racial disparity; Racial Groups; Treatment rates; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Ohio; Pennsylvania; Co-infection; HIV; Hepatitis C virus; Racial disparity; Treatment rates; Immunopathology; Mixed infection; Retroviridae; Hepatic disease; AIDS; Epidemiology; Immune deficiency; Lentivirus; Infection; Virus; Treatment; Medical prescription; Viral disease; Race; Digestive diseases; Human immunodeficiency virus; Flaviviridae; Hepacivirus; Viral hepatitis C
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2008.06.041

Summary Background Treatment rates for hepatitis C virus (HCV) have not been compared directly between HCV mono-infected and HCV–HIV co-infected patients in academic center settings. Methods We prospectively enrolled consecutive mono-infected and co-infected subjects at three academic centers in the USA. Clinical and laboratory data were gathered through interviews and medical records. Logistic regression analysis was used to determine the factors associated with treatment prescription for HCV. Results The 241 HCV mono-infected and 158 HCV–HIV co-infected subjects were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the latter group. The co-infected subjects were less likely to have a liver biopsy (43.7% vs. 71.4%, p < 0.001) or ever receive treatment for HCV (32.3% vs. 62.2%, p < 0.001). In bivariate analysis, subjects not prescribed treatment for HCV were more likely to be black, have HIV co-infection, and have ongoing alcohol abuse. In multivariate analysis, black race (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.28–0.70) and HIV co-infection (OR 0.33, 95% CI 0.21–0.53) were independently associated with non-prescription of treatment. Conclusions Black race and HIV co-infection are associated with a lower likelihood of treatment for HCV. Addressing comorbidities in these populations may help to reduce such treatment disparities.