Attitudes and potential barriers towards hepatitis C treatment in patients with and without HIV coinfection

Int J STD AIDS. 2018 Mar;29(4):334-340. doi: 10.1177/0956462417725462. Epub 2017 Aug 18.

Abstract

This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.

Keywords: Human immunodeficiency virus; barriers; hepatitis C virus; survey; treatment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Antiviral Agents / therapeutic use*
  • Coinfection / drug therapy
  • Coinfection / virology*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • Health Services Accessibility
  • Hepacivirus
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / virology
  • Humans
  • Liver Cirrhosis / drug therapy
  • Los Angeles
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Self Report
  • Socioeconomic Factors
  • Treatment Outcome

Substances

  • Anti-Retroviral Agents
  • Antiviral Agents