Awareness of Hepatitis C Infection Among Women With and At Risk for HIV |
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| Authors: | Mardge H. Cohen Dennis Grey Judith A. Cook Kathryn Anastos Eric Seaberg Michael Augenbraun Pam Burian Marion Peters Mary Young Audrey French |
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| Affiliation: | (1) CORE Center, Cook County Bureau of Health Services, Chicago, IL, USA;(2) Department of Medicine, Stroger (formerly Cook County) Hospital, Chicago, IL, USA;(3) Department of Medicine, Rush Medical College, Chicago, IL, USA;(4) Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA;(5) Epidemiology, Population Health & Medicine, Montefiore Medical Center, Bronx, NY, USA;(6) Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;(7) Health Science Center of Brooklyn, State University of New York, Brooklyn, NY, USA;(8) AIDS Healthcare Foundation, Los Angeles, CA, USA;(9) University of California of SF, San Francisco, CA, USA;(10) Department of Medicine, Georgetown Medical Center, Washington, DC, USA |
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| Abstract: | BACKGROUND Treatment guidelines recommend all HIV/HCV-co-infected persons be considered for hepatitis C virus (HCV) treatment, yet obstacles to testing and accessing treatment for HCV continue for women. OBJECTIVE To assess awareness of HCV, and describe diagnostic referrals and HCV treatment among women in the Women’s Interagency HIV Study (WIHS). DESIGN Prospective epidemiologic cohort. PARTICIPANTS Of 3,768 HIV-infected and uninfected women in WIHS, 1,166 (31%) were HCV antibody positive. MEASUREMENTS AND MAIN RESULTS Awareness of HCV infection and probability of referrals for diagnostic evaluations and treatment using logistic regression. Follow-up HCV information was available for 681 (390 died, 15 withdrew, 80 missed visit) in 2004. Of these 681, 522 (76.7%) reported knowing their HCV diagnosis. Of these, 247 of 522 (47.3%) stated their providers recommended a liver biopsy, whereas 139 of 247 or 56.3% reported having a liver biopsy. A total of 170 of 522 (32.6%) reported being offered treatment and 74.1% (n = 126 of 170) reported receiving HCV treatment. In multivariate regression analyses, African-American race, Hispanic/Latina ethnicity, poverty, and current crack/cocaine/heroin use were negatively associated with treatment referrals, whereas elevated alanine aminotransferase (ALT) was associated with increased likelihood of referral and increased likelihood of treatment. CONCLUSION One quarter of women with HCV in this cohort were not aware of their diagnosis. Among those aware of their HCV, 1 in 4 received liver biopsy and treatment for HCV. Both provider and patient education interventions regarding HCV testing and HCV treatment options and guidelines are needed to enhance HCV awareness and participation in HCV evaluation and treatment. Part of this work was presented at the XV International AIDS Conference, July 11, 2004. The WIHS centers (Principal Investigators) are located at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC Metropolitan Consortium (Mary Young); the Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). |
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| Keywords: | women hepatitis C HIV race drug use therapy |
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