The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: A retrospective cohort study

Huiting Ma; Conrado Franco Villalobos; Martin St-Jean; Oghenowede Eyawo; Miriam Ruth Lavergne; Lianping Ti; Mark W. Hull; Benita Yip; Lang Wu; Robert S. Hogg; Rolando Barrios; Jean A. Shoveller; Julio S.G. Montaner; Viviane D. Lima

doi:10.1186/s12913-018-3119-5

The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: A retrospective cohort study

Huiting Ma, Conrado Franco Villalobos, Martin St-Jean, Oghenowede Eyawo, Miriam Ruth Lavergne, Lianping Ti, Mark W. Hull, Benita Yip, Lang Wu, Robert S. Hogg, Rolando Barrios, Jean A. Shoveller, Julio S.G. Montaner, Viviane D. Lima

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

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.

Original language	English
Article number	319
Journal	BMC Health Services Research
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12913-018-3119-5
Publication status	Published - May 2 2018
Externally published	Yes

Bibliographical note

Funding Information:
JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA031043–01). The sponsors had no role in the design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all data in the study and had final responsibility to submit for publication.

Funding Information:
JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA03104301).

Publisher Copyright:
© 2018 The Author(s).

ASJC Scopus Subject Areas

Health Policy

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12913-018-3119-5

Cite this

Ma, H., Villalobos, C. F., St-Jean, M., Eyawo, O., Lavergne, M. R., Ti, L., Hull, M. W., Yip, B., Wu, L., Hogg, R. S., Barrios, R., Shoveller, J. A., Montaner, J. S. G., & Lima, V. D. (2018). The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: A retrospective cohort study. BMC Health Services Research, 18(1), Article 319. https://doi.org/10.1186/s12913-018-3119-5

Ma, H, Villalobos, CF, St-Jean, M, Eyawo, O, Lavergne, MR, Ti, L, Hull, MW, Yip, B, Wu, L, Hogg, RS, Barrios, R, Shoveller, JA, Montaner, JSG & Lima, VD 2018, 'The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada: A retrospective cohort study', BMC Health Services Research, vol. 18, no. 1, 319. https://doi.org/10.1186/s12913-018-3119-5

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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",

abstract = "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.",

author = "Huiting Ma and Villalobos, {Conrado Franco} and Martin St-Jean and Oghenowede Eyawo and Lavergne, {Miriam Ruth} and Lianping Ti and Hull, {Mark W.} and Benita Yip and Lang Wu and Hogg, {Robert S.} and Rolando Barrios and Shoveller, {Jean A.} and Montaner, {Julio S.G.} and Lima, {Viviane D.}",

note = "Funding Information: JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA031043–01). The sponsors had no role in the design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all data in the study and had final responsibility to submit for publication. Funding Information: JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA03104301). Publisher Copyright: {\textcopyright} 2018 The Author(s).",

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month = may,

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doi = "10.1186/s12913-018-3119-5",

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T1 - The impact of HCV co-infection status on healthcare-related utilization among people living with HIV in British Columbia, Canada

T2 - A retrospective cohort study

AU - Ma, Huiting

AU - Villalobos, Conrado Franco

AU - St-Jean, Martin

AU - Eyawo, Oghenowede

AU - Lavergne, Miriam Ruth

AU - Ti, Lianping

AU - Hull, Mark W.

AU - Yip, Benita

AU - Wu, Lang

AU - Hogg, Robert S.

AU - Barrios, Rolando

AU - Shoveller, Jean A.

AU - Montaner, Julio S.G.

AU - Lima, Viviane D.

N1 - Funding Information: JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA031043–01). The sponsors had no role in the design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all data in the study and had final responsibility to submit for publication. Funding Information: JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). VDL is funded by a grant from the Canadian Institutes of Health Research (PJT-148595), by a Scholar Award from the Michael Smith Foundation for Health Research and a New Investigator award from the Canadian Institutes of Health Research. OE is supported by a Canadian Institutes of Health Research doctoral award. MH has received grant support from the National Institute on Drug Abuse (NIDA R01DA03104301). Publisher Copyright: © 2018 The Author(s).

PY - 2018/5/2

Y1 - 2018/5/2

N2 - 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.

AB - 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.

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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

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

UN SDGs

Access to Document

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