We recruited a total of 399 subjects (241 HCV mono-infected and 158 HCV–HIV co-infected). The two groups were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the HCV–HIV co-infected group (). HCV–HIV co-infected subjects also had a lower mean (SD) body mass index compared with the HCV mono-infected subjects (25.8 (5.5) vs. 29.1 (5.6), p < 0.001).
Baseline characteristics of HCV mono-infected and HCV–HIV co-infected subjects
A total of 241 subjects (60.4%) underwent liver biopsy. HCV–HIV co-infected subjects were less likely to have a liver biopsy performed than HCV mono-infected subjects (43.7% vs. 71.4%, p < 0.001). The HCV–HIV co-infected patients had lower mean (SD) fibrosis scores (2.1 (1.3) vs. 2.5 (1.5), p = 0.04) and inflammation scores (2.6 (1.6) vs. 3.7 (2.0), p = 0.001) compared to HCV mono-infected subjects ().
A total of 201 subjects (50.4%) were ever prescribed HCV therapy. HCV–HIV co-infected subjects were less likely to have ever initiated treatment for HCV than HCV mono-infected subjects (32.3% vs. 62.2%, p < 0.001). In addition, subjects not prescribed treatment were more likely to be of black race, HIV co-infected, and have ongoing alcohol abuse ().
Characteristics of subjects prescribed treatment for HCV vs. those who were not prescribed treatment for HCV
When we examined factors associated with non-receipt of HCV therapy separately among HCV mono-infected and HCV–HIV co-infected subjects, fewer subjects of black race were prescribed treatment in each group (though the difference did not reach statistical significance in the HCV–HIV co-infected group) (). In univariate analysis, black race (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.26–0.59), HIV co-infection (OR 0.29, 95% CI 0.19–0.44), and ongoing alcohol abuse (OR 0.53, 95% CI 0.30–0.89) were associated with a lesser likelihood of receiving treatment for HCV (). In multivariate analysis, black race (adjusted OR 0.44, 95% CI 0.28–0.70) and HIV co-infection (adjusted OR 0.33, 95% CI 0.21–0.53) were associated with a lower likelihood of treatment prescription, while anemia was associated with an increased likelihood of treatment prescription (adjusted OR 2.16, 95% CI 1.26–3.70) (). When we analyzed the HCV mono-infected and HCV–HIV co-infected groups separately, black race was associated with a lower likelihood of receiving treatment in each group, with a lower odds ratio in the latter group compared with the former.
A comparison of subjects prescribed treatment for HCV with those who were not prescribed treatment by HIV status
Factors associated with treatment prescription for HCV (univariate logistic regression)
Factors associated with treatment prescription for HCV (multivariate logistic regression)a
Subjects who were HCV–HIV co-infected were more likely to have at least one comorbidity compared with HCV mono-infected subjects (80.4% vs. 63.9%, p < 0.001; results not shown). The following comorbidities/contraindications were more likely to be present in blacks (p < 0.05): diabetes, autoimmune disease, intravenous drug use, and anemia prior to treatment. Blacks were also more likely to have at least one comorbidity compared to non-blacks, but this did not reach statistical significance (74.2% vs. 67.7%, p = 0.16).