The rate of treatment of chronic hepatitis C in patients co-infected with HIV in an urban medical centre

被引:34
作者
Restrepo, A [1 ]
Johnson, TC [1 ]
Widjaja, D [1 ]
Yarmus, L [1 ]
Meyer, K [1 ]
Clain, DJ [1 ]
Bodenheimer, HC [1 ]
Min, AD [1 ]
机构
[1] Beth Israel Med Ctr, Div Digest Dis, Dept Med, New York, NY 10003 USA
关键词
hepatitis C virus; human immunodeficiency virus; co-infection; interferon; treatment;
D O I
10.1111/j.1365-2893.2005.00548.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection is common. HIV co-infection results in a higher rate of histologic progression and shorter interval to HCV-related cirrhosis. Successful treatment of HCV with interferon-based therapy reduces the morbidity and mortality of patients. Significant factors may limit the availability of treatment in co-infected patients. The rate of treatment of HCV and limiting factors to treatment in a co-infected population in an urban setting were determined. A retrospective review of co-infected patients was conducted at our liver and gastrointestinal (GI) clinics for treatment of HCV from July 2001 to June 2002. Treatment of HCV and reasons for nontreatment were recorded. A total of 104 HCV/HIV co-infected patients were identified. Seventy-two per cent were males. Mean age was 47.2 years (32-72). Seventy-four of the 82 (90%) with identifiable risk factors for HCV infection had a history of intravenous drug use (IVDU). Twenty per cent (21/104) of the total underwent a liver biopsy. Sixty-seven per cent who had a liver biopsy were treated. Overall, sixteen patients were treated. Eighty-eight (85%) patients were not treated for the following reasons: 13 refused treatment, and 75 were ineligible. Of the ineligible patients, 40% were noncompliant with visits, 15% were active substance abusers, 13% had decompensated cirrhosis, 8% had significant active psychiatric conditions and 24% had significant co-morbid disease. A majority of patients co-infected with HCV/HIV had a IVDU history. Most co-infected patients were not eligible for HCV treatment. A majority of noncandidates had potentially modifiable psychosocial factors leading to nontreatment.
引用
收藏
页码:86 / 90
页数:5
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共 19 条
  • [1] The prevalence of hepatitis C virus infection in the United States, 1988 through 1994
    Alter, MJ
    Kruszon-Moran, D
    Nainan, OV
    McQuillan, GM
    Gao, FX
    Moyer, LA
    Kaslow, RA
    Margolis, HS
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (08) : 556 - 562
  • [2] RECOMBINANT INTERFERON-ALPHA FOR CHRONIC HEPATITIS-C IN PATIENTS POSITIVE FOR ANTIBODY TO HUMAN-IMMUNODEFICIENCY-VIRUS
    BOYER, N
    MARCELLIN, P
    DEGOTT, C
    DEGOS, F
    SAIMOT, AG
    ERLINGER, S
    BENHAMOU, JP
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1992, 165 (04) : 723 - 726
  • [3] CHUNG R, 2002, 9 C RETR OPP INF 24
  • [4] Surprisingly small effect of antiviral treatment in patients with hepatitis C
    Falck-Ytter, Y
    Kale, H
    Mullen, KD
    Sarbah, SA
    Sorescu, L
    McCullough, AJ
    [J]. ANNALS OF INTERNAL MEDICINE, 2002, 136 (04) : 288 - 292
  • [5] Hepatitis C virus and human immunodeficiency virus coinfection in an urban population: Low eligibility for interferon treatment
    Fleming, CA
    Craven, DE
    Thornton, D
    Tumilty, S
    Nunes, D
    [J]. CLINICAL INFECTIOUS DISEASES, 2003, 36 (01) : 97 - 100
  • [6] Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection.
    Fried, MW
    Shiffman, ML
    Reddy, KR
    Smith, C
    Marinos, G
    Goncales, FL
    Haussinger, D
    Diago, M
    Carosi, G
    Dhumeaux, D
    Craxi, A
    Lin, A
    Hoffman, J
    Yu, J
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (13) : 975 - 982
  • [7] Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis
    Graham, CS
    Baden, LR
    Yu, E
    Mrus, JM
    Carnie, J
    Heeren, T
    Koziel, MJ
    [J]. CLINICAL INFECTIOUS DISEASES, 2001, 33 (04) : 562 - 569
  • [8] Poor response to interferon treatment for chronic hepatitis C in human immunodeficiency virus-infected haemophiliacs
    Hayashi, K
    Fukuda, Y
    Nakano, I
    Katano, Y
    Yokozaki, S
    Toyoda, H
    Takamatsu, J
    Hayakawa, T
    [J]. HAEMOPHILIA, 2000, 6 (06) : 677 - 681
  • [9] Lack of interference between ribavirin and nucleosidic analogues in HIV/HCV co-infected individuals undergoing concomitant antiretroviral and anti-HCV combination therapy
    Landau, A
    Batisse, D
    Piketty, C
    Jian, R
    Kazatchkine, MD
    [J]. AIDS, 2000, 14 (12) : 1857 - 1858
  • [10] Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial
    Manns, MP
    McHutchison, JG
    Gordon, SC
    Rustgi, VK
    Shiffman, M
    Reindollar, R
    Goodman, ZD
    Koury, K
    Ling, MH
    Albrecht, JK
    [J]. LANCET, 2001, 358 (9286) : 958 - 965