August 28, 2013

ART adherence, heart disease key in whether anti-HCV therapy begins

Site_Logo_New2Good adherence to antiretroviral therapy (ART) raised chances that HIV/HCV-coinfected people would start anti-HCV therapy, according to results of a 479-person study in France. Having children or having cardiovascular disease or respiratory distress lowered chances that anti-HCV therapy would begin.

Coinfection with hepatitis C virus (HCV) and HIV is common because the viruses share transmission routes and affect people with similar risk behaviors. Many coinfected people do not start anti-HCV therapy—despite documented benefits—usually because of contraindications between the two sets of drugs or because of poor adherence to ART that suggests similarly poor adherence to anti-HCV therapy. To identify factors influencing starting guideline-based HCV therapy in a large cohort of coinfected people, French investigators conducted this study.

The study involved 479 coinfected people, 194 of whom (40.5%) started anti-HCV therapy for the first time between 2005 and 2011 according to current recommendations in France: a Metavir score greater than F1 for liver fibrosis; HCV genotype 2 or 3 infection; or HCV genotype 1 or 4 infection and an HCV viral load below 800,000 IU/mL, whatever the fibrosis score. Researchers compared clinical and biological data between patients who did and did not start anti-HCV therapy.

Multivariate statistical analysis determined that physician perception of good antiretroviral adherence more than doubled chances that a person would start anti-HCV therapy (odds ratio [OR] 2.37, 95% confidence interval [CI] 1.17 to 4.81, P = 0.017).

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