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Hepatitis C treatment experiences and decision making among patients living with HIV infection

Carol Bova, Lisa Fink Ogawa, Susan Sullivan-Bolyai

    The Journal of the Association of Nurses in AIDS Care : JANAC
    |October 27, 2009
    PubMed

    Insights

    Hepatitis C virus (HCV) treatment barriers in HIV-infected adults include fears and past experiences. Facilitating factors involve illness management, patient relationships, and sobriety. Improving HCV treatment uptake is crucial.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Public Health

    Background:

    • Hepatitis C virus (HCV) infection poses significant liver-related health risks for HIV-infected individuals in the U.S.
    • Despite effective HIV management, HCV contributes to substantial morbidity and mortality in this population.
    • HCV treatment uptake remains low, affecting 15%-30% of coinfected individuals.

    Purpose of the Study:

    • To explore the experiences and decision-making processes related to HCV treatment among adults coinfected with HIV.
    • To identify barriers and facilitators influencing HCV treatment initiation and adherence in this specific patient group.

    Main Methods:

    • Qualitative study involving 39 adults with HIV and HCV coinfection.
    • Participants were divided into an HCV-treated cohort (n=16) and an HCV-nontreatment cohort (n=23).
    • In-depth interviews were conducted, with a maximum of three interviews per participant in the treated group.

    Main Results:

    • Identified two primary treatment barriers: fears associated with treatment and vicarious experiences.
    • Identified four key facilitating factors: prior experience with illness management, strong patient-provider relationships, achieving sobriety, and a proactive approach to treatment.
    • Developed a preliminary model to inform the design of interventions aimed at improving HCV treatment.

    Conclusions:

    • Understanding patient experiences is vital for addressing low HCV treatment uptake.
    • Interventions targeting identified barriers and leveraging facilitating factors are needed.
    • Further research is essential to test and validate interventions for enhancing HCV evaluation and treatment in HIV-coinfected patients.

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