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

TitleThe impact of HIV/HCV co-infection on health care utilization and disability: results of the ACTG Longitudinal Linked Randomized Trials (ALLRT) Cohort.
Publication TypeJournal Article
Year of Publication2011
AuthorsLinas BP, Wang B, Smurzynski M, Losina E, Bosch RJ, Schackman BR, Rong J, Sax PE, Walensky RP, Schouten J, Freedberg KA
JournalJ Viral Hepat
Volume18
Issue7
Pagination506-12
Date Published2011 Jul
ISSN1365-2893
KeywordsAdult, CD4 Lymphocyte Count, Coinfection, Delivery of Health Care, Disabled Persons, Emergency Service, Hospital, Female, Hepatitis C, HIV Infections, Hospitals, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors
Abstract

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.

DOI10.1111/j.1365-2893.2010.01325.x
Alternate JournalJ. Viral Hepat.
PubMed ID20546501
PubMed Central IDPMC3347883
Grant ListK01 AI073193 / AI / NIAID NIH HHS / United States
K01 AI073193-04 / AI / NIAID NIH HHS / United States
K01 AI073193-05 / AI / NIAID NIH HHS / United States
K01 DA017179 / DA / NIDA NIH HHS / United States
K01 DA017179-05 / DA / NIDA NIH HHS / United States
K01AI073193 / AI / NIAID NIH HHS / United States
K01DA017179 / DA / NIDA NIH HHS / United States
K24 AI062476 / AI / NIAID NIH HHS / United States
K24 AI062476-05 / AI / NIAID NIH HHS / United States
K24AI062476 / AI / NIAID NIH HHS / United States
P30 AI050410 / AI / NIAID NIH HHS / United States
P30 AI060354 / AI / NIAID NIH HHS / United States
P30 AI060354-07 / AI / NIAID NIH HHS / United States
P30AI060354 / AI / NIAID NIH HHS / United States
R37 AI042006 / AI / NIAID NIH HHS / United States
R37 AI042006-14 / AI / NIAID NIH HHS / United States
R37AI42006 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI038855-09 / AI / NIAID NIH HHS / United States
U01 AI038858 / AI / NIAID NIH HHS / United States
U01 AI038858-07 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01AI038855 / AI / NIAID NIH HHS / United States
U01AI038858 / AI / NIAID NIH HHS / United States
U01AI068634 / AI / NIAID NIH HHS / United States
U01AI68636 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068634-07 / AI / NIAID NIH HHS / United States
UM1 AI068636-06 / AI / NIAID NIH HHS / United States