Citation

Oramasionwu CU, Moore HN, Toliver JC. AIDS Patient Care STDS 2014; 28(5): 228-239.

Copyright

(Copyright © 2014, Mary Ann Liebert Publishers)

DOI

10.1089/apc.2014.0033

PMID

unavailable

Abstract

This review synthesized the literature for barriers to HCV antiviral treatment in persons with HIV/HCV co-infection. Searches of PubMed, Embase, CINAHL, and Web of Science were conducted to identify relevant articles. Articles were excluded based on the following criteria: study conducted outside of the United States, not original research, pediatric study population, experimental study design, non-HIV or non-HCV study population, and article published in a language other than English. Sixteen studies met criteria and varied widely in terms of study setting and design. Hepatic decompensation was the most commonly documented absolute/nonmodifiable medical barrier. Substance use was widely reported as a relative/modifiable medical barrier. Patient-level barriers included nonadherence to medical care, refusal of therapy, and social circumstances. Provider-level barriers included provider inexperience with antiviral treatment and/or reluctance of providers to refer patients for treatment. There are many ongoing challenges that are unique to managing this patient population effectively. Documenting and evaluating these obstacles are critical steps to managing and caring for these individuals in the future. In order to improve uptake of HCV therapy in persons with HIV/HCV co-infection, it is essential that barriers, both new and ongoing, are addressed, otherwise, treatment is of little benefit. © 2014, Mary Ann Liebert, Inc.

Language: en

Keywords

Humans; United States; human; Severity of Illness Index; systematic review; Substance-Related Disorders; bipolar disorder; suicidal ideation; substance use; suicide attempt; major depression; complication; addiction; comorbidity; drug abuse; kidney failure; psychology; review; substance abuse; alcohol abuse; Human immunodeficiency virus infection; albumin; albumin blood level; HIV Infections; cannabis addiction; treatment refusal; drug dependence; hepatitis C; Hepatitis C; anemia; creatinine; creatinine blood level; antivirus agent; treatment contraindication; Coinfection; decompensated liver cirrhosis; international normalized ratio; CD4 lymphocyte count; Substance Abuse, Intravenous; Hepacivirus; bilirubin; bilirubin blood level; treatment duration; Antiviral Agents; ascites; health care disparity; antiviral therapy; mixed infection; severity of illness index; esophagus varices; drug effects