ISSN 1472-4863. Published by i-Base.
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Polly Clayden, HIV i-Base
Most HCV-positive IDUs do not receive HCV treatment. M Sulkowski and co-workers from Johns Hopkins in the US presented findings from a study to determine the proportion of HIV-positive and HIV-negative IDU (former and active) in their programme who are eligible for and initiate HCV therapy with pegylated interferon (pegINF) + ribavirin (RBV) in the absence of geographic and financial barriers (treatment was offered free and on-site).
The study enrolled 332 subjects (172 HIV/HCV co-infected; 158 HCV mono-infected). HIV-co-infected IDU were younger (41 to <44 years) and were more likely to be African American (90% to >74%), have a monthly income >$500 (52% to >23%) than those with HCV alone. The investigators reported no difference in the prevalence of mental illness (~64%), alcohol use (~20%), or interest in receiving HCV treatment (~93%).
Table 1: Characteristics of HIV/HCV patients
Of the treatment-eligible IDU, about 40% initiated HCV therapy, defined as at least pegINF injection (31/75 HIV/HCV, 41%; 27/80 HCV, 36%).
The investigators concluded: “While approximately 50% of HIV/HCV-co-infected IDU were ineligible for HCV treatment, most (~80%) of HCV-mono-infected IDU were treatment-eligible. Despite the removal of financial and geographic barriers, only around 40% of treatment-eligible IDU initiated HCV treatment. Strategies are needed to increase HCV treatment uptake among IDU.”
comment
A paper from Mehta and colleagues (also at Hopkins) that came out last year, looking at access to HCV care and treatment among coinfected people is worth reading in this context.
Ref: Sulkowski M, Mehta S, Moore R et al. Low rates of HCV therapy among treatment-eligible injection drug users with and without HIV Co-infection. 14th CROI, 2007, Los Angeles. Poster abstract 947.
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