Why Are Some Veterans Who Are Coinfected With Hepatitis C and HIV More Likely to Be Treated for HCV Than Others?

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Why Are Some Veterans Who Are Coinfected With Hepatitis C and HIV More Likely to

Be Treated for HCV Than Others?

Posted 28 October 2008 @ 07:00 am ESTPR RSS Print E-Mail

SAN FRANCISCO, Oct. 28 /PRNewswire/ -- Researchers from the E.DeBakey VA

Medical Center, led by Kramer, Ph.D., looked at apopulation of U.S.

veterans to determine the patient, provider, and facilitycharacteristics that

determined how likely after diagnosis for hepatitis Cvirus patients who have HIV

are treated for HCV. This retrospective study usedthe Hepatitis C Clinical Case

Registry to identify patients who had bothinfections and who had visited a VA

facility at least twice in a six-yearperiod. " This is a very large cohort

(N=7,103) of patients with laboratoryconfirmed HCV-HIV coinfection (maybe one of

the largest ever examined) that isvery representative of VA users, " said Dr.

Kramer, but she cautions, " It isdifficult to draw conclusions to all patients

with HCV-HIV coinfection becausethe VA cohort tends to be predominately male and

relatively low income. "

Of those patients in the registry who had HCV and HIV, 10.3% were treatedwithin

two years of HCV diagnosis. The researchers went on to identify thefactors that

resulted in treatment for those patients. Race was a patientfactor that

determined who was more likely to be treated for HCV. Patients whowere black or

Hispanic were not as likely to be treated as compared to whitepatients after HCV

diagnosis. Other determining factors were sex (malesweren't as likely to be

treated as females), drug use, psychosis, high HIVviral load, and genotype 1 or

4. Patients were more likely to be treated ifthey were diagnosed with HCV more

recently; were also diagnosed withcirrhosis; and had high CD4 counts,

hemoglobin, and persistently high liverenzyme scores.

The study's authors also identified provider and facility characteristicsthat

determined if a patient who also had HIV was treated for HCV. Patientswere more

likely to be treated if the facility in which they were seen hadonly one

inpatient hospital compared to those with multiple sites and if theprovider was

a specialist for HCV.

" The study highlights the important role of facilities and providers, inaddition

to the known patient-related factors, in explaining variation andpossibly

outcomes of care in HCV-infected patients, " said Hashem El-Serag, MD. " These

factors have been largely ignored in current research. We plan toinvestigate the

role of facility factors in HCV treatment receipt incoinfected patients further

by including data from a recently completedfacility survey addressing facility

factors specifically involved in HCVcare. "

Abstract title:

Patient, provider, and facility characteristics of HCV antiviral treatmentamong

US veterans with HCV-HIV coinfection.

AASLD is the leading medical organization for advancing the science andpractice

of hepatology. Founded by physicians in 1950, AASLD's vision is toprevent and

cure liver diseases. This year's Liver Meeting, held in SanFrancisco,

California, October 31 - November 4, will bring together more than7,000

researchers from 55 countries.

A pressroom will be available from November 1 at the annual meeting. Forcopies

of abstracts and press releases, or to arrange for pre-conferenceresearch

interviews contact Bologna at 703-299-9766. To pre-register,call Ann

at 703-299-9766.

Press releases and all abstracts are available online at www.aasld.org .

This release was issued through The Xpress Press News Service, merginge-mail and

satellite distribution technologies to reach business analysts andmedia outlets

worldwide. For more information, visithttp://www.XpressPress.com

SOURCE American Association for the Study of Liver Diseases