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The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study
BACKGROUND: The burden of HCV among those living with HIV remains a major public health challenge. We aimed to characterize trends in healthcare-related visits (HRV) of people living with HIV (PLW-HIV) and those living with HIV and HCV (PLW-HIV/HCV), in British Columbia (BC), and to identify risk fa...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932856/ https://www.ncbi.nlm.nih.gov/pubmed/29720155 http://dx.doi.org/10.1186/s12913-018-3119-5 |
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author | Ma, Huiting Villalobos, Conrado Franco St-Jean, Martin Eyawo, Oghenowede Lavergne, Miriam Ruth Ti, Lianping Hull, Mark W. Yip, Benita Wu, Lang Hogg, Robert S. Barrios, Rolando Shoveller, Jean A. Montaner, Julio S. G. Lima, Viviane D. |
author_facet | Ma, Huiting Villalobos, Conrado Franco St-Jean, Martin Eyawo, Oghenowede Lavergne, Miriam Ruth Ti, Lianping Hull, Mark W. Yip, Benita Wu, Lang Hogg, Robert S. Barrios, Rolando Shoveller, Jean A. Montaner, Julio S. G. Lima, Viviane D. |
author_sort | Ma, Huiting |
collection | PubMed |
description | BACKGROUND: The burden of HCV among those living with HIV remains a major public health challenge. We aimed to characterize trends in healthcare-related visits (HRV) of people living with HIV (PLW-HIV) and those living with HIV and HCV (PLW-HIV/HCV), in British Columbia (BC), and to identify risk factors associated with the highest HRV rates over time. METHODS: Eligible individuals, recruited from the BC Seek and Treat for Optimal Prevention of HIV/AIDS population-based retrospective cohort (N = 3955), were ≥ 18 years old, first started combination antiretroviral therapy (ART) between 01/01/2000–31/12/2013, and were followed for ≥6 months until 31/12/2014. The main outcome was HRV rate. The main exposure was HIV/HCV co-infection status. We built a confounder non-linear mixed effects model, adjusting for several demographic and time-dependent factors. RESULTS: HRV rates have decreased since 2000 in both groups. The overall age-sex standardized HRV rate (per person-year) among PLW-HIV and PLW-HIV/HCV was 21.11 (95% CI 20.96–21.25) and 41.69 (95% CI 41.51–41.88), respectively. The excess in HRV in the co-infected group was associated with late presentation for ART, history of injection drug use, sub-optimal ART adherence and a higher number of comorbidities. The adjusted HRV rate ratio for PLW-HIV/HCV in comparison to PLW-HIV was 1.18 (95% CI 1.13–1.24). CONCLUSIONS: Although HRV rates have decreased over time in both groups, PLW-HIV/HCV had 18% higher HRV than those only living with HIV. Our results highlight several modifiable risk factors that could be targeted as potential means to minimize the disease burden of this population and of the healthcare system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3119-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5932856 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59328562018-05-09 The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study Ma, Huiting Villalobos, Conrado Franco St-Jean, Martin Eyawo, Oghenowede Lavergne, Miriam Ruth Ti, Lianping Hull, Mark W. Yip, Benita Wu, Lang Hogg, Robert S. Barrios, Rolando Shoveller, Jean A. Montaner, Julio S. G. Lima, Viviane D. BMC Health Serv Res Research Article BACKGROUND: The burden of HCV among those living with HIV remains a major public health challenge. We aimed to characterize trends in healthcare-related visits (HRV) of people living with HIV (PLW-HIV) and those living with HIV and HCV (PLW-HIV/HCV), in British Columbia (BC), and to identify risk factors associated with the highest HRV rates over time. METHODS: Eligible individuals, recruited from the BC Seek and Treat for Optimal Prevention of HIV/AIDS population-based retrospective cohort (N = 3955), were ≥ 18 years old, first started combination antiretroviral therapy (ART) between 01/01/2000–31/12/2013, and were followed for ≥6 months until 31/12/2014. The main outcome was HRV rate. The main exposure was HIV/HCV co-infection status. We built a confounder non-linear mixed effects model, adjusting for several demographic and time-dependent factors. RESULTS: HRV rates have decreased since 2000 in both groups. The overall age-sex standardized HRV rate (per person-year) among PLW-HIV and PLW-HIV/HCV was 21.11 (95% CI 20.96–21.25) and 41.69 (95% CI 41.51–41.88), respectively. The excess in HRV in the co-infected group was associated with late presentation for ART, history of injection drug use, sub-optimal ART adherence and a higher number of comorbidities. The adjusted HRV rate ratio for PLW-HIV/HCV in comparison to PLW-HIV was 1.18 (95% CI 1.13–1.24). CONCLUSIONS: Although HRV rates have decreased over time in both groups, PLW-HIV/HCV had 18% higher HRV than those only living with HIV. Our results highlight several modifiable risk factors that could be targeted as potential means to minimize the disease burden of this population and of the healthcare system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3119-5) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-02 /pmc/articles/PMC5932856/ /pubmed/29720155 http://dx.doi.org/10.1186/s12913-018-3119-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Ma, Huiting Villalobos, Conrado Franco St-Jean, Martin Eyawo, Oghenowede Lavergne, Miriam Ruth Ti, Lianping Hull, Mark W. Yip, Benita Wu, Lang Hogg, Robert S. Barrios, Rolando Shoveller, Jean A. Montaner, Julio S. G. Lima, Viviane D. The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title | The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title_full | The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title_fullStr | The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title_full_unstemmed | The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title_short | The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: a retrospective cohort study |
title_sort | impact of hcv co-infection status on healthcare-related utilization among people living with hiv in british columbia, canada: a retrospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932856/ https://www.ncbi.nlm.nih.gov/pubmed/29720155 http://dx.doi.org/10.1186/s12913-018-3119-5 |
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