ArticleAIDS patient care and STDs2009
Treat early or wait and monitor? A qualitative analysis of provider hepatitis C virus treatment decision-making in the context of HIV coinfection.
Article in AIDS patient care and STDs, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Care2Cure: A randomized controlled trial protocol for evaluating nurse case management to improve the hepatitis C care continuum within HIV primary care.Research in nursing & health · 2018Trial
- HCV treatment barriers among HIV/HCV co-infected patients in the US: a qualitative study to understand low uptake among marginalized populations in the DAA era.Journal of public health (Oxford, England) · 2019Article
- Article
- Barriers to hepatitis C antiviral therapy in HIV/HCV co-infected patients in the United States: a review.AIDS patient care and STDs · 2014Review
- Differences in outpatient care and treatment utilization for patients with HIV/HCV coinfection, HIV, and HCV monoinfection, a cross-sectional study.BMC infectious diseases · 2014Article
- Formal hepatitis C education enhances HCV care coordination, expedites HCV treatment and improves antiviral response.Liver international : official journal of the International Association for the Study of the Liver · 2013Article
- Chronic hepatitis C and antiviral treatment regimens: where can psychology contribute?Journal of consulting and clinical psychology · 2013Review
- Breaking down the barriers to hepatitis C virus (HCV) treatment among individuals with HCV/HIV coinfection: action required at the system, provider, and patient levels.The Journal of infectious diseases · 2013Review
- Best strategies for global HCV eradication.Liver international : official journal of the International Association for the Study of the Liver · 2013Review
- Challenges facing providers caring for HIV/HCV-coinfected patients.Qualitative health research · 2012Article
- Patient and provider characteristics associated with the decision of HIV coinfected patients to start hepatitis C treatment.AIDS patient care and STDs · 2011Article
- Treatment for hepatitis C virus genotype 1 infection in HIV-infected individuals on methadone maintenance therapy.Drug and alcohol dependence · 2011Article
- Factors that influence an HIV coinfected patient's decision to start hepatitis C treatment.AIDS patient care and STDs · 2009Article
- Provider and patient correlates of provider decisions to recommend HCV treatment to HIV co-infected patients.Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Liver disease is a leading cause of death among patients with HIV coinfected with hepatitis C (HCV); yet, studies show that less than 10% receive HCV treatment, in part because of limited treatment response, high treatment toxicity, and psychosocial barriers to treatment readiness. Using a process model framework, we sought to explore the factors and processes by which providers make HCV treatment decisions for HIV-coinfected patients. We conducted 22 semistructured interviews with primary care providers and support staff at three HIV clinics in Los Angeles, California, in which rates of HCV treatment uptake varied from 10% to 38%. Providers agreed that stable HIV disease, favorable genotype, and significant signs of liver disease progression are all signs of need for treatment. However, two divergent treatment approaches emerged for genotype 1 and 4 patients with minimal disease, and in definitions of patient readiness. Providers with lower treatment rates preferred to delay treatment in hopes of better future treatment options, and were more conservative in requiring complete mental health screens and treatment and abstinence from substance use. Conversely, providers with higher treatment rates viewed all patients as needing treatment as soon as possible, and defined readiness more leniently, with some willing to treat even in the context of untreated depression and drug use, so long as ability to adhere well was demonstrated. Regardless of whether an aggressive or cautious approach to treatment is used, development of effective programs for promoting patient treatment readiness is critical to ensuring greater treatment uptake.
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Registered trials
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