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Awareness of Hepatitis C Infection Among Women With and At Risk for HIV

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Abstract

BACKGROUND

Treatment guidelines recommend all HIV/HCV-co-infected persons be considered for hepatitis C virus (HCV) treatment, yet obstacles to testing and accessing treatment for HCV continue for women.

OBJECTIVE

To assess awareness of HCV, and describe diagnostic referrals and HCV treatment among women in the Women’s Interagency HIV Study (WIHS).

DESIGN

Prospective epidemiologic cohort.

PARTICIPANTS

Of 3,768 HIV-infected and uninfected women in WIHS, 1,166 (31%) were HCV antibody positive.

MEASUREMENTS AND MAIN RESULTS

Awareness of HCV infection and probability of referrals for diagnostic evaluations and treatment using logistic regression. Follow-up HCV information was available for 681 (390 died, 15 withdrew, 80 missed visit) in 2004. Of these 681, 522 (76.7%) reported knowing their HCV diagnosis. Of these, 247 of 522 (47.3%) stated their providers recommended a liver biopsy, whereas 139 of 247 or 56.3% reported having a liver biopsy. A total of 170 of 522 (32.6%) reported being offered treatment and 74.1% (n = 126 of 170) reported receiving HCV treatment. In multivariate regression analyses, African-American race, Hispanic/Latina ethnicity, poverty, and current crack/cocaine/heroin use were negatively associated with treatment referrals, whereas elevated alanine aminotransferase (ALT) was associated with increased likelihood of referral and increased likelihood of treatment.

CONCLUSION

One quarter of women with HCV in this cohort were not aware of their diagnosis. Among those aware of their HCV, 1 in 4 received liver biopsy and treatment for HCV. Both provider and patient education interventions regarding HCV testing and HCV treatment options and guidelines are needed to enhance HCV awareness and participation in HCV evaluation and treatment.

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Acknowledgment

The WIHS is funded by the National Institute of Allergy and Infectious Diseases, with supplemental funding from the National Cancer Institute, the National Institute of Child Health & Human Development, the National Institute on Drug Abuse, the Agency for Health Care Policy and Research, and the National Center for Research Resources. Grant numbers U01-AI-35004, U01-AI-31834, U01-AI-34994, U01-AI-34989, U01-HD-32632, U01-AI-34993, U01-AI-42590, MO1-RRR00071, MO1-RR00079, and MO1-RR00083.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. CORE Center, Cook County Bureau of Health Services, Chicago, IL, USA

    Mardge H. Cohen & Audrey French

  2. Department of Medicine, Stroger (formerly Cook County) Hospital, Chicago, IL, USA

    Mardge H. Cohen & Audrey French

  3. Department of Medicine, Rush Medical College, Chicago, IL, USA

    Mardge H. Cohen & Audrey French

  4. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Dennis Grey & Judith A. Cook

  5. Epidemiology, Population Health & Medicine, Montefiore Medical Center, Bronx, NY, USA

    Kathryn Anastos

  6. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Eric Seaberg

  7. Health Science Center of Brooklyn, State University of New York, Brooklyn, NY, USA

    Michael Augenbraun

  8. AIDS Healthcare Foundation, Los Angeles, CA, USA

    Pam Burian

  9. University of California of SF, San Francisco, CA, USA

    Marion Peters

  10. Department of Medicine, Georgetown Medical Center, Washington, DC, USA

    Mary Young

Authors
  1. Mardge H. Cohen
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  2. Dennis Grey
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  3. Judith A. Cook
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  4. Kathryn Anastos
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  5. Eric Seaberg
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  6. Michael Augenbraun
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  7. Pam Burian
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  8. Marion Peters
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  9. Mary Young
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  10. Audrey French
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Corresponding author

Correspondence to Mardge H. Cohen.

Additional information

The WIHS centers (Principal Investigators) are located at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC Metropolitan Consortium (Mary Young); the Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange).

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Cohen, M.H., Grey, D., Cook, J.A. et al. Awareness of Hepatitis C Infection Among Women With and At Risk for HIV. J GEN INTERN MED 22, 1689–1694 (2007). https://doi.org/10.1007/s11606-007-0395-x

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  • DOI: https://doi.org/10.1007/s11606-007-0395-x

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