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Hepatitis C treatment uptake and response among human immunodeficiency virus/hepatitis C virus-coinfected patients in a large integrated healthcare system.

U.S. guidelines recommend that patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) be prioritized for HCV treatment with direct-acting antiviral agents (DAAs), but the high cost of DAAs may contribute to disparities in treatment uptake and outcomes. We evaluated DAA initiation and effectiveness in HIV/HCV-coinfected patients in a U.S.-based healthcare system during October 2014-December 2017. Of 462 HIV/HCV-coinfected patients, 276 initiated DAAs (70% cumulative proportion treated over three years). Lower likelihood of DAA initiation was observed among patients with Medicare (government-sponsored insurance) versus commercial insurance (adjusted rate ratio [aRR] = 0.62, 95% CI = 0.46-0.84), patients with drug abuse diagnoses (aRR = 0.72, 95% CI = 0.54-0.97), patients with CD4 cell count

Authors: Lam, Jennifer O JO; Hurley, Leo B LB; Chamberland, Scott S; Champsi, Jamila H JH; Gittleman, Laura C LC; Korn, Daniel G DG; Lai, Jennifer B JB; Quesenberry, Charles P CP; Ready, Joanna J; Saxena, Varun V; Seo, Suk I SI; Witt, David J DJ; Silverberg, Michael J MJ; Marcus, Julia L JL

International journal of STD & AIDS. 2019 Jun ;30(7):689-695. Epub 2019-05-02.

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