Yale University

Improving the Hepatitis C Cascade of Care Among HIV/HCV Coinfected Persons of Color in Connecticut

Principle Investigator(s):

Funder: Health Resources and Services Administration (HRSA)
Project period:
Grant Type: Research

Abstract Text:

Although PLWH are living longer due to advances in HIV antiretroviral treatment, those who are co-infected with HCV have increased morbidity and mortality from liver disease. There has been a revolution in HCV treatment due to introduction of direct acting agents (DAAs) which are highly effective (>95% cure rates) even in persons with HIV/HCV co-infection, are better tolerated and can be administered for short courses (8-12 weeks for most). Unfortunately, there are multiple barriers to achieving cure in the co-infected population, which are provider-based (inadequate
screening, referral to HCV providers, prescription of DAAs) and non-provider-based (high costs, low public awareness, limited public health and health system response, stigma and discrimination). These barriers are particularly problematic for persons of color.

In CT, limited public health resources have led to an incomplete epidemiologic profile of the HIV/HCV co-infected population. It is currently estimated that the prevalence of coinfected persons is 1500-2200, with 70% (1060-1540) being persons of color; these, however, are likely to be underestimates. While a number of clinics, particularly Ryan White funded clinics and other Federally Qualified Health Centers (FQHCs) have embarked on curative treatment, the scope and effectiveness of these efforts are not fully monitored. CT needs an integrated statewide approach to reduce HCV morbidity and mortality among PLWH who are low-income, underinsured or uninsured and are from racial and ethnic minorities.