The impact of HIV/HCV co-infection on health care utilization and disability: results of the ACTG Longitudinal Linked Randomized Trials (ALLRT) Cohort

Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA.
Journal of Viral Hepatitis (Impact Factor: 3.91). 07/2011; 18(7):506-12. DOI: 10.1111/j.1365-2893.2010.01325.x
Source: PubMed


HIV/hepatitis C virus (HCV) co-infection places a growing burden on the HIV/AIDS care delivery system. Evidence-based estimates of health services utilization among HIV/HCV co-infected patients can inform efficient planning. We analyzed data from the ACTG Longitudinal Linked Randomized Trials (ALLRT) cohort to estimate resource utilization and disability among HIV/HCV co-infected patients and compare them to rates seen in HIV mono-infected patients. The analysis included HIV-infected subjects enrolled in the ALLRT cohort between 2000 and 2007 who had at least one CD4 count measured and completed at least one resource utilization data collection form (N = 3143). Primary outcomes included the relative risk of hospital nights, emergency department (ED) visits, and disability days for HIV/HCV co-infected vs HIV mono-infected subjects. When controlling for age, sex, race, history of AIDS-defining events, current CD4 count and current HIV RNA, the relative risk of hospitalization, ED visits, and disability days for subjects with HIV/HCV co-infection compared to those with HIV mono-infection were 1.8 (95% CI: 1.3-2.5), 1.7 (95% CI: 1.4-2.1), and 1.6 (95% CI: 1.3-1.9) respectively. Programs serving HIV/HCV co-infected patients can expect approximately 70% higher rates of utilization than expected from a similar cohort of HIV mono-infected patients.

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    • "Human Immunodeficiency Virus (HIV) and hepatitis C virus (HCV) monoinfection have been the subjects of ample research over the past two decades; however, HIV/HCV coinfection has only recently been documented as a growing medical concern in the United States [1]. Combination HIV antiretroviral therapy and combination HCV antiviral therapy have been recommended since the late 1990s, as they each greatly reduce patient morbidity and mortality [2,3]. "
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