Author information
1
The George Washington University, School of Medicine and Health Sciences , 2300 I Street NW , Washington, District of Columbia, United States , 20052 ; JeffreyRoberson@gwu.edu.
2
VA Medical Center, Infectious Diseases Section, Washington, District of Columbia, United States.
3
The George Washington University, Infectious Diseases Division, Washington, District of Columbia, United States ; myerslagasca@gmail.com.
4
The George Washington University, Infectious Diseases Division, Washington, District of Columbia, United States ; virginia.kan@va.gov.
Abstract
Treatment of chronic Hepatitis C Virus (HCV) infection included use of pegylated interferon-based regimens prior to 2014 and direct acting agents (DAA) since 2014 at the VA Medical Center in Washington, DC. We compared the continua of care between our HCV/HIV co-infected and HCV mono-infected patients during 2008-2015. A review of summary data from our local HCV Clinical Case Registry was conducted for the interferon treatment era (2008-2013) and the DAA era (2014-2015). Data were analyzed on a modified HCV Continuum of Care (CoC) based on these stages: HCV diagnosis, engagement in medical care, HCV treatment, and HCV sustained virologic response (SVR) for differences between HCV/HIV co-infected and HCV mono-infected patients. All patients had 88% engagement in primary care during 2008-2013. HCV mono-infected and HCV/HIV co-infected patients had similar treatment (6% vs. 5%, p=0.6622) and HCV SVR (1% vs. 0.5%, p= 0.1737) rates in the interferon era. However, more HCV/HIV co-infected patients were engaged in care (93% vs. 87%, p=0.0044), accessed HCV treatment (36% vs. 23%, p< 0.0001), and achieved HCV SVR (31% vs. 21% p=0.0002) compared to mono-infected patients in the DAA era. Both HCV/HIV co-infected and HCV mono-infected patients achieved higher SVR of >86% after DAA treatment. Although improvements were seen for treatment and SVR among HCV mono-infected patients, better rates for care engagement, HCV treatment, and SVR were realized for HCV/HIV co-infected patients in the DAA era.