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Factors that influence an HIV coinfected patient's decision to start hepatitis C treatment

Karen Chan Osilla1, Gery Ryan, Laveeza Bhatti

  • 1RAND Corporation, Santa Monica, California 90407, USA. karenc@rand.org

AIDS Patient Care and Stds
|November 26, 2009
PubMed

Insights

For patients with HIV and hepatitis C (HCV), treatment decisions involve patient and provider factors. Patient readiness, HIV stability, and provider communication influence HCV treatment acceptance.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Liver disease is a major cause of illness and death in patients with HIV and hepatitis C (HCV) coinfection.
  • Despite this, few coinfected patients receive HCV treatment, highlighting a gap in care.
  • Patient acceptance of treatment recommendations is crucial for initiating HCV therapy.

Purpose of the Study:

  • To explore factors influencing treatment decision-making for HCV in patients coinfected with HIV.
  • To understand the patient and provider perspectives in the HCV treatment decision process.

Main Methods:

  • Semistructured interviews were conducted with 35 patients coinfected with HIV and HCV.
  • Interviews also included 11 primary care providers at three HIV clinics in Los Angeles.
  • A process model framework guided the exploration of decision-making factors.

Main Results:

  • Patient factors influencing decisions include HIV stability, perceived need for HCV treatment, readiness, tolerance for side effects, absence of substance abuse, and mental health stability.
  • A trusting patient-provider relationship is significant.
  • Providers recognize their communication style impacts patient decisions.

Conclusions:

  • HCV treatment decisions involve a collaborative process between patient and provider.
  • Mutual agreement on the need for treatment and patient readiness are essential for treatment initiation.
  • Provider communication and patient-provider relationships play a key role in treatment acceptance.

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