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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?

October 28, 2008

SAN FRANCISCO, Oct. 28 /PRNewswire/ — Researchers from the Michael E. DeBakey VA Medical Center, led by Jennifer Kramer, Ph.D., looked at a population of U.S. veterans to determine the patient, provider, and facility characteristics that determined how likely after diagnosis for hepatitis C virus patients who have HIV are treated for HCV. This retrospective study used the Hepatitis C Clinical Case Registry to identify patients who had both infections and who had visited a VA facility at least twice in a six-year period. “This is a very large cohort (N=7,103) of patients with laboratory confirmed HCV-HIV coinfection (maybe one of the largest ever examined) that is very representative of VA users,” said Dr. Kramer, but she cautions, “It is difficult to draw conclusions to all patients with HCV-HIV coinfection because the 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 treated within two years of HCV diagnosis. The researchers went on to identify the factors that resulted in treatment for those patients. Race was a patient factor that determined who was more likely to be treated for HCV. Patients who were black or Hispanic were not as likely to be treated as compared to white patients after HCV diagnosis. Other determining factors were sex (males weren’t as likely to be treated as females), drug use, psychosis, high HIV viral load, and genotype 1 or 4. Patients were more likely to be treated if they were diagnosed with HCV more recently; were also diagnosed with cirrhosis; and had high CD4 counts, hemoglobin, and persistently high liver enzyme scores.

The study’s authors also identified provider and facility characteristics that determined if a patient who also had HIV was treated for HCV. Patients were more likely to be treated if the facility in which they were seen had only one inpatient hospital compared to those with multiple sites and if the provider was a specialist for HCV.

“The study highlights the important role of facilities and providers, in addition to the known patient-related factors, in explaining variation and possibly outcomes of care in HCV-infected patients,” said Hashem El-Serag, MD. “These factors have been largely ignored in current research. We plan to investigate the role of facility factors in HCV treatment receipt in coinfected patients further by including data from a recently completed facility survey addressing facility factors specifically involved in HCV care.”

Abstract title:

Patient, provider, and facility characteristics of HCV antiviral treatment among US veterans with HCV-HIV coinfection.

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD’s vision is to prevent and cure liver diseases. This year’s Liver Meeting, held in San Francisco, California, October 31 – November 4, will bring together more than 7,000 researchers from 55 countries.

A pressroom will be available from November 1 at the annual meeting. For copies of abstracts and press releases, or to arrange for pre-conference research interviews contact Gregory Bologna at 703-299-9766. To pre-register, call Ann Tracy at 703-299-9766.

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

This release was issued through The Xpress Press News Service, merging e-mail and satellite distribution technologies to reach business analysts and media outlets worldwide. For more information, visit http://www.xpresspress.com/

American Association for the Study of Liver Diseases

CONTACT: Media: Gregory Bologna, +1-703-299-9766, gbologna@aasld.org,Press Room: November 1-4, 2008, Moscone West, Room: 2020, +1-415-348-4403;Researcher Hashem El-Serag, MD, +1-713-794-8640, hasheme@bcm.tmc.edu

Web site: http://www.aasld.org/




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