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Abstract Details
Low Utilization of Direct-Acting Antiviral Agents in a Large National Cohort of HIV and HCV Coinfected Medicare Patients in the United States: Implications for HCV Elimination
J Public Health Manag Pract. 2022 Mar-Apr 01;28(2):130-134.doi: 10.1097/PHH.0000000000001147.
Ping Du1, Jeah Jung, Yamini Kalidindi, Kevin Farrow, Thomas Riley 3rd, Cynthia Whitener
Author information
Department of Medicine (Drs Du, Riley, and Whitener) Department of Public Health Sciences (Dr Du), and Department of Pharmacy (Dr Farrow), College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania; and Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania (Dr Jung and Ms Kalidindi).
Abstract
Hepatitis C virus (HCV) infection is common in people living with HIV/AIDS (PLWHA). The advent of direct-acting antiviral agents (DAAs) has made HCV elimination a realistic goal. We conducted a retrospective cohort study using the US Medicare Fee-For-Service claims data and outpatient prescription drug data to assess the HCV DAA initiation and completion among newly diagnosed HIV-HCV-coinfected Medicare patients enrolled in 2014-2016. DAA initiation was defined as filling at least 1 prescription of DAAs during 2014-2016. DAA completion was defined as taking an 8-week or longer DAA treatment course for patients without cirrhosis and a 12-week or longer treatment duration for those with cirrhosis. Among 12 152 HIV-HCV-coinfected Medicare patients, 20.9% received the DAA treatment in 2014-2016. The average time from HCV diagnosis to DAA initiation was 277 days. The overall DAA completion rate was 92% among 2537 patients who used DAAs. Interventions are needed to improve DAA uptake in PLWHA.