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Published on: April 9, 2014
Meeting the Challenge: Hepatitis C Virus and HIV Care Experiences Among HIV Specialty Providers
Leah M Adams1, Benjamin Balderson2, Bruce J Packett3
11 Department of Psychology, George Mason University , Fairfax, Virginia.
Insights
HIV specialists actively treat Hepatitis C virus (HCV) coinfection, aligning with screening guidelines but varying treatment likelihood based on risk. They possess knowledge but face barriers to optimal HCV care.
Area of Science:
- Infectious Diseases
- Hepatology
- Public Health
Background:
- Hepatitis C virus (HCV) coinfection significantly increases mortality in HIV-positive adults.
- The role and experiences of HIV specialists in treating HCV remain understudied.
- Understanding these experiences is crucial for improving care in coinfected populations.
Purpose of the Study:
- To examine the experiences of HIV specialists in treating patients with HCV.
- To assess barriers and facilitators to providing HCV care.
- To evaluate HCV screening practices and treatment likelihood based on patient risk factors.
Main Methods:
- A brief online survey was administered to 168 HIV specialists (physicians, NPs, PAs, pharmacists).
- Survey assessed caseloads, barriers, facilitators, treatment likelihood, and screening practices.
- Screening practices were compared against CDC guidelines.
Main Results:
- Most specialists treated HIV/HCV coinfected patients; fewer treated HCV monoinfected patients.
- Screening practices generally aligned with CDC guidelines.
- Treatment prescription likelihood varied based on patient risk profiles, despite high provider knowledge.
Conclusions:
- HIV specialists are actively involved in HCV care, particularly for coinfected patients.
- Key barriers hinder optimal HCV care delivery, necessitating specialized guidance.
- Targeted support for managing complex histories, including HIV coinfection, is recommended for these providers.
Abstract:
Hepatitis C virus (HCV) is frequently comorbid with HIV infection and is independently associated with a significant increase in all-cause mortality among HIV-positive adults. HIV specialists' role and experiences in treating HCV has been understudied, especially among those providers who actively treat patients with HCV. We conducted a brief online survey of HIV specialists (physicians, nurse practitioners, physician assistants, and prescribing pharmacists) who treat patients with HCV to examine their experiences with treating these patients (HCV monoinfected, HIV/HCV coinfected). Survey questions assessed providers' annual caseloads, barriers, and facilitators to providing HCV care, likelihood of providing HCV treatment to patients with various risk factors, and the extent to which their HCV screening practices aligned with CDC (Centers for Disease Control) guidelines for patients from various risk groups. A total of 168 HIV care providers were included in analyses. Nearly all specialists surveyed actively treated HIV/HCV coinfected patients, while fewer treated any HCV monoinfected patients. Providers' screening practices typically aligned with guidelines across patient groups, but their likelihood of prescribing HCV treatment to patients varied across patients' risk profiles. Providers endorsed high levels of knowledge to treat HCV-infected patients, but highlighted key barriers to providing optimal care. Given that HIV specialists are an active group treating patients with HCV, they may benefit from specialized guidance on managing HCV in patients with complex histories, including comorbid HIV infection.
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