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Hepatitis C Knowledge and Recent Diagnosis Affect Hepatitis C Treatment Willingness in Persons Living With HIV
Edward R Cachay1, Francesca J Torriani1, Lucas Hill2
1Department of Medicine, Division of Infectious Diseases and Global Public Health, UC San Diego, San Diego, CA.
Insights
Low hepatitis C (HCV) knowledge and long-term infection decrease willingness to start HCV treatment in people living with HIV (PLWH). Improving HCV knowledge is key to increasing treatment uptake among PLWH.
Area of Science:
- Infectious Diseases
- Hepatology
- Public Health
Background:
- People living with HIV (PLWH) often have co-infection with hepatitis C virus (HCV).
- Understanding factors influencing HCV treatment willingness is crucial for effective care in this population.
- Health literacy and specific HCV knowledge may impact treatment decisions.
Purpose of the Study:
- To assess the impact of health literacy and hepatitis C (HCV) knowledge on HCV treatment willingness among people living with HIV (PLWH).
- To identify predictors of low health literacy, HIV knowledge, and HCV knowledge.
- To determine factors associated with willingness to initiate HCV treatment.
Main Methods:
- Cross-sectional analysis of 151 PLWH co-infected with HCV.
- Utilized health literacy, HIV literacy, and HCV knowledge inventories.
- Employed mixed-model linear and logistic regression to identify predictors.
Main Results:
- Prevalence of low health literacy, HIV knowledge, and HCV knowledge was 10%, 32%, and 29%, respectively.
- Low HCV knowledge was associated with female sex, non-White ethnicity, and longer duration of HCV diagnosis.
- Living with HCV for a decade decreased willingness to treat (OR: 0.23), while high HCV knowledge increased it (OR: 1.27).
Conclusions:
- Low hepatitis C (HCV) knowledge is a significant barrier to treatment initiation in people living with HIV (PLWH).
- Longer duration of HCV infection (≥10 years) is associated with reduced willingness to undergo treatment.
- Interventions to improve HCV knowledge and address long-standing infections are needed to enhance treatment uptake.
Background:
We assessed the impact of health literacy and hepatitis C (HCV) knowledge on HCV treatment willingness among people living with HIV (PLWH) at an academic HIV clinic.
Methods:
Cross-sectional analysis of PLWH coinfected with HCV who completed health literacy, HIV literacy, and HCV knowledge inventories. We estimated the prevalence of low health literacy, HIV knowledge, and HCV knowledge sampled from 3-comparison groups: PLWH not referred for HCV, referred but who "not showed" to the HCV clinic, and referred and attended the HCV clinic. We used mixed-model linear and logistic regression to ascertain predictors of low health literacy, HIV knowledge, HCV knowledge, and predictors of willingness to start HCV treatment.
Results:
We enrolled 151 PLWH; 17% were female, 38% non-White, and 60% without a high-school education. Approximately, 68% were men who have sex with men, of whom 62% used intravenous drugs. The prevalence of low health, HIV knowledge, and HCV knowledge was 10%, 32%, and 29%, respectively. Predictors of low health literacy were being Hispanic, cirrhotic, and not completing high-school education. Low HCV knowledge was observed in female, non-White, and those diagnosed with HCV for a decade. In adjusted analyses, PLWH living with HCV for a decade (OR: 0.23) were less likely to be very willing to be treated for HCV. By contrast, those with high HCV knowledge were more likely to be very willing to receive treatment (OR: 1.27).
Conclusion:
Low HCV knowledge and living with HCV for at least a decade are under-recognized negative predictors for PLWH's willingness to receive HCV treatment.
Clinical Trials Registration:
ClinicaTrials.gov identifier: NCT20170991.
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