Integrating treatment for hepatitis C virus infection into an HIV clinic

In the United States, one-third of human immunodeficiency virus (HIV)-infected patients are also coinfected with hepatitis C virus (HCV). Of 228 coinfected patients whose charts were reviewed in our 2000 study, only 2 had received therapy with interferon. To address low rates of treatment, in 2001 we implemented a program to shift the primary responsibility for oversight of care for HCV-infected patients from the liver clinic to HIV primary care clinicians and to provide education and support regarding adherence to patients. Critical elements of the program include education of HIV clinicians with regard to treatment for HCV infection, establishment of a coinfection clinic in the HIV clinic, assignment of a full-time Registered Nurse for monitoring and support of patients undergoing treatment for HCV infection, and development of a weekly peer group for the coinfected patients. Preliminary treatment results for patients in the program suggest that this approach has promise for improving outcomes of treatment among coinfected patients.