Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
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
_version_ 1783319884510265344
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
work_keys_str_mv AT mahuiting theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT villalobosconradofranco theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT stjeanmartin theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT eyawooghenowede theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT lavergnemiriamruth theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT tilianping theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT hullmarkw theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT yipbenita theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT wulang theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT hoggroberts theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT barriosrolando theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT shovellerjeana theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT montanerjuliosg theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT limavivianed theimpactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT mahuiting impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT villalobosconradofranco impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT stjeanmartin impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT eyawooghenowede impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT lavergnemiriamruth impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT tilianping impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT hullmarkw impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT yipbenita impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT wulang impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT hoggroberts impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT barriosrolando impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT shovellerjeana impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT montanerjuliosg impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy
AT limavivianed impactofhcvcoinfectionstatusonhealthcarerelatedutilizationamongpeoplelivingwithhivinbritishcolumbiacanadaaretrospectivecohortstudy