Timing of treatment initiation of direct-acting antivirals for HIV/HCV coinfected and HCV monoinfected patients

AIDS Care
Donald P RiceLisa M Chirch

Abstract

Direct-acting antiviral therapy is safe and cost-effective for the treatment of hepatitis C virus (HCV) infection. However, variability in drug payment rules represents a barrier to treatment that may disproportionately affect certain populations. We conducted a retrospective cohort study among HIV/HCV coinfected and HCV monoinfected patients using Kaplan-Meier and Fisher's exact test to analyze the time from the prescription of a direct-acting antiviral agent to delivery to the patient. Variables with significance p < .20 in univariate analysis were included in a Cox regression model. Factors associated with faster treatment were Infectious Diseases office setting (p = .01), public insurance payer (p = .01), and initial approval of requested regimen (p = .01). The presence of other liver disease was associated with delay in treatment (p = .05). Unrestrictive Medicare and Medicaid regulations resulted in more rapid delivery of medication compared to private payers. Fibrosis level, Child-Pugh class and HIV status did not significantly change time to treatment.

References

Sep 27, 2002·The New England Journal of Medicine·Michael W FriedJian Yu
Dec 2, 2009·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Amit G SingalPhilip S Schoenfeld
Jul 19, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Andrew Aronsohn, Donald Jensen
Apr 5, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Natasha K MartinMatthew Hickman
Apr 12, 2014·The New England Journal of Medicine·Kris V KowdleyUNKNOWN ION-3 Investigators
Mar 18, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David B ReinJohn W Ward
Sep 22, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Anthony CousienYazdan Yazdanpanah
Nov 18, 2015·The New England Journal of Medicine·John W Ward, Jonathan H Mermin
Dec 3, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David P DurhamJeffrey P Townsend
Feb 28, 2016·Journal of Hepatology·Cindy ZahndUNKNOWN Swiss Hepatitis C Cohort Studies
Apr 12, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Vincent Lo ReJay R Kostman

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