Theme: Clinical Research Year: 2019
Background: The advent of direct acting antivirals (DAAs) has eliminated disparities in SVR (e.g. cure)
rates between patients living with hepatitis C (HCV) and those with HCV/HIV co-infection. Although
elimination of the SVR gap has been remarkable, other disparities in the present DAA era may persist
between patients living with HCV and HCV/HIV co-infection. The objectives of this study were to
compare the prevalence of psychiatric, alcohol, and substance use disorders between HCV patients with
and without HIV co-infection who received HCV treatment with DAAs, and to identify independent
predictors of longer time to treatment intervals (i.e. the time between initial clinical visit for HCV
evaluation and the HCV treatment start date).
Method: This study recruited a sample of patients living with HCV and HCV/HIV co-infection who
received HCV treatment with DAAs (n=275) at a university affiliated clinic between January 2013 and
July 2017. Binomial logistic regression was used to identify independent predictors of longer time to
treatment intervals.
Results: Compared to patients with HCV mono-infection, patients with HCV/HIV co-infection had a
higher number of days between their initial clinic visit for HCV evaluation and their HCV treatment start
date (349.29 ± 272.92 vs. 229.46 ± 206.54, p=0.001). Patients with HCV/HIV co-infection had a higher
prevalence of psychiatric disorders (24% vs. 43%, p=0.001) and alcohol use (21% vs. 7%, p=0.001) and
substance use disorders (37% vs. 15%, p=0.000) than patients with HCV mono-infection. In multivariate
analysis, HCV/HIV co-infection was positively associated with longer time to treatment intervals
(OR=2.11, CI:1.169 – 3.807).
Conclusion: HCV/HIV co-infection was an independent predictor of longer time to HCV treatment
intervals—the odds of longer time to treatment intervals was 2 times higher among patients with
HCV/HIV co-infection. Findings highlight a need for future studies to examine and ascertain the reasons
why time to treatment disfavors patients with HCV/HIV co-infection—who are receiving services and
care from the same providers and clinics as patients with HCV mono-infection.
Disclosure of Interest Statement: NIL