Hepatitis C and HIV Co-infection

Graham, Camilla S.

doi:10.1001/jama.2015.1111

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…However, the effect of such interventions on prevention of HCV transmission and disease burden has not been evaluated (10). In addition, the economic benefits to both prisons and the outside community of such programs, and the burden on state and Federal budgets, are not known (10, 20). Therefore, the objective of our study was to evaluate the health and economic benefits of multiple HCV screening strategies in US prisons on HCV prevention in the general population.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

He¹,

Li²,

Roberts³

et al. 2015

Ann Intern Med

141

169

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Background The prevalence of hepatitis C virus (HCV) in United States prisoners is high; however, HCV testing and treatment is rare. Infected inmates released back into society contribute to the spread of HCV in the general population. Routine hepatitis screening of inmates followed by treatment with new therapies offers hope to reduce ongoing HCV transmission. Objective To evaluate the health and economic impact of HCV screening and treatment in prisons on the HCV epidemic in the society. Design An agent-based microsimulation model of transmission and progression of HCV. Data Sources Published literature. Target population Population in US prisons and general community. Time horizon 30 years. Perspective Societal. Interventions Risk-based and universal opt-out hepatitis C screening in prisons followed by treatment in a portion of patients. Outcome measures Prevention of HCV transmission and associated-disease in prisons and society, costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), and total prison budget. Results of Base-Case Analysis Implementing risk-based and opt-out screening could diagnose 41 900–122 700 new HCV cases in the next 30 years in prisons. Compared with no screening, these scenarios could prevent 5500–12 700 new HCV infections caused by releasees, where about 90% of averted infections would have occurred outside of prisons. HCV screening could also prevent 4200–11 700 liver-related deaths. The ICERs of screening scenarios were between $19 600–$29 200/QALY, and the respective 1st year prison budget were between $900 and $1150 million. Prisons would require an additional 12.4% of their current healthcare budget to implement such interventions. Results of Sensitivity Analysis Results were sensitive to the time horizon; and ICERs otherwise remained below $50 000 per QALY. Limitations Data on transmission network, re-infection rate and opt-out HCV screening rate are lacking. Conclusions Universal opt-out HCV screening in prisons is highly cost-effective and would reduce HCV transmission and HCV-associated diseases primarily in the outside community. Investing in US prisons to manage hepatitis C is a strategic approach to address the current epidemic.

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Section: Introductionmentioning

confidence: 99%

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

He¹,

Li²,

Roberts³

et al. 2015

Ann Intern Med

141

169

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“…In the CHeCS, 38% of HCV antibody (Ab)-positive patients had no follow-up HCV RNA testing documented in the electronic database; 62% had no liver biopsy between 2001 and 2010 [10][11][12]. Even larger gaps exist for patients coinfected with human immunodeficiency virus (HIV) and HCV [13]. Furthermore, HCV treatments have been historically less effective and/ or intolerable for many patients.…”

mentioning

confidence: 99%

Streamlining Screening to Treatment: The Hepatitis C Cascade of Care at Kaiser Permanente Mid-Atlantic States

Jonas

Rodriguez

Redd³

et al. 2016

Clin Infect Dis.

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Hepatitis C virus (HCV) screening is recommended for patients at risk and/or born during , but screening gaps persist. This new program screens target populations and enhances care linkage for chronically HCV-infected patients. Kaiser Permanente Mid-Atlantic States created a comprehensive HCV screening pathway, supported by a HCV care coordinator. The testing pathway includes HCV antibody (Ab), automatic HCV RNA for Ab-positive patients, coinfection and liver health tests, vibration-controlled transient elastography (VCTE), and a physician referral. A total of 11 200 patients were screened; 3.25% were HCV Ab positive, and 100% of Ab-positive patients received HCV RNA testing. Of HCV Ab-positive patients, 75.9% had chronic HCV, of which 80.8% underwent VCTE. HCV diagnosis was communicated to 94% of patients, and 70.9% had HCV documented in the electronic health record. The pathway shows promise in closing gaps, including improving HCV RNA testing, communicating diagnoses, and assessing liver fibrosis. Improved testing and linkage could increase curative treatment access.

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“…HCV Patients with Human immunode ciency virus (HIV) co-infection are 3 times more likely to develop cirrhosis or liver decompensation than those infected with Hepatitis C alone [4].…”

Section: Introductionmentioning

confidence: 99%

Sero-prevalence of HCV among HIV infected adult patients attending Comprehensive Care Center at Kenyatta National Hospital

Ukio¹,

Anzala

Mureithi

2019

Preprint

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Objective The objective of the study was to assess the prevalence of Hepatitis C virus infection and associated risk factors amongst HIV/AIDS adult patients in a sub-Saharan setting. Results Two hundred and forty (240) HIV/AIDS patients were recruited from Comprehensive Care Center at KNH.A total of 21 days were spent in the recruitment. The mean age of the participants was 41 years with a standard deviation of 11. The ages ranged between 18 years and 76 years. Majority of the participants were between 30 and 50 years of age. 70% of recruited participants were residing in Nairobi, 16% in Kiambu, 4% in Machakos, 3% in Kajiado and 7% in other counties. 72% of all recruited participants were females, whereas males accounted for 28%. The Prevalence of HCV among Adult HIV/AIDS was 0%. Among risk factors assessed, sexually transmitted infections accounted for 20.4% of all risk factors. None of the participants had a history of intravenous drug use.

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Hepatitis C and HIV Co-infection

Cited by 7 publications

References 12 publications

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

Streamlining Screening to Treatment: The Hepatitis C Cascade of Care at Kaiser Permanente Mid-Atlantic States

Sero-prevalence of HCV among HIV infected adult patients attending Comprehensive Care Center at Kenyatta National Hospital

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