Only one in 10 people with HCV and an indication offered PrEP, study finds
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Despite indications for PrEP being prevalent among people with hepatitis C, most patients were unaware of PrEP, had never been offered PrEP and were not using PrEP, researchers found.
“While hepatitis C and HIV share many of the same risk factors, people with HCV are not often discussed as a priority population for HIV prevention,” Kristi C. Hill, MD, intern at The Johns Hopkins Hospital, told Healio. “Our research group was already conducting a larger study evaluating the overlap of transmission networks for HIV and hepatitis C virus (HCV) that involved the collection of epidemiologic data for patients with HIV and/or HCV.”
Hill added, “We thought it would be important to understand HIV risk factors and opportunities for HIV prevention in individuals with hepatitis C monoinfection.”
To do so, Hill and colleagues conducted GRAVITY — an observational study that collected epidemiologic data from individuals with HCV and/or HIV in Washington, D.C. and Baltimore.
According to the study, the prevalence of PrEP indications was determined using epidemiologic survey responses. Bivariate and multivariable analyses were then used to assess for associations between PrEP indications and PrEP awareness, access and interest.
Among 314 HCV monoinfected participants included in GRAVITY, 109 (35%) had an indication for PrEP. 48 (44%) had a drug use indication alone, 40 (37%) had a sexual indication alone and 21 (19%) had both drug use and sexual indications.
Data showed that 85 (27%) participants had heard of PrEP, 32 (10%) had been offered PrEP by a provider, 114 (38%) were interested or maybe interested in PrEP and six (2%) were currently taking PrEP. Bivariate analysis showed that PrEP awareness was significantly associated with study site (P < .0001), race (P = .0003), age (P < .0001) and sexual PrEP indication (P = .04). Study site was the only factor that remained significant after regression analysis (P = .0002).
“Many patients with hepatitis C may benefit from PrEP, but PrEP awareness remains suboptimal in this patient population,” Hill said. “If a patient tests positive for hepatitis C, this can serve as a prompt for the provider to further explore HIV risk and prevention with their patient and to engage in education and shared decision-making about PrEP.”
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