Analyzing the linkage status of co-infected HIV and HCV patients
Abstract
According to the CDC, HIV/HCV co-infection triples the risk for liver failure and liver-related deaths. However, linkage to care for co-infection has been shown to be effective. We examined if our HIV and HCV co-infected patients are linked to care. Furthermore, we identified the attributes of co-infected patients and how it relates to linkage status.
Proposal Summary
The CARE Initiative is an opt-out HIV/HCV screening program in the Memorial Health University Medical Center (MHUMC) Emergency Department (ED), that serves 35 counties inclusive of rural areas. Since the inception of both programs, we have identified 817 cases of new and known HIV, and 596 cases of new and known cases of HCV. Our automated EMR notifies the CARE Initiative Linkage Specialists through in basket messaging. Linkage Specialists follow up with both new and known HIV/HCV patients, provide result notifications, counseling, and linkage to care. Linkage Specialists employ a set protocol for linkage to care of patients. Since the inception of our HCV program in 2017, we have identified 40 cases of HIV and HCV co-infection with varying linkage status and characteristics. 22% of these cases are from rural areas in southeast Georgia and southern South Carolina. We identified 60% co-infected patients who concurrently receive care for HIV and HCV, of which 25% are from rural areas. Approximately 15% receive care for HIV but not HCV of which 50% are from rural areas. 15% of our co-infected patients are not receiving care for either infection, with no identification from rural areas. Furthermore, we identified 10% of co-infected patients who are currently deceased. Data trends suggest that co-infected patients engaged in both HIV and HCV care are often clients of Ryan White Part B clinics where HIV and HCV medical services are rendered. Also, these patients are more likely to have discontinued use of drugs and alcohol and consistently attend medical appointments. Patients who receive care for only HIV or did not receive care for both infections, typically struggle with substance abuse, rural and urban unstable housing, and continuously missed appointments at linkage facilities. Additionally, there are some cases in which patients are terminally ill and HCV treatment is not a priority. With continuous linkage to care, patients with consistently missed appointments will be addressed through one-on-one conversations to address barriers during their next ED visit. Patients with ongoing substance abuse problems will be referred to rehabilitation centers before linkage to care for HCV can take place.
Relevance And Significance
Patients who are engaged in HIV care are more likely to engage in HCV care as needed, including patients living in rural areas. Referral of co-infected patients to Ryan White clinics help to reduce disease burden. Addressing attributes of co-infected patients such as ongoing substance abuse and continuously missed appointments, will further improve the wellbeing of co-infected patients.
Session Format
Presentation Session
Keywords
HIV, HCV, Linkage, Co-infection
Location
Savannah, Ga.
Publication Type and Release Option
Presentation (Open Access)
Recommended Citation
Okafor, Chidinma B.; Wiggins, Jean; and O'Ree, Marianna, "Analyzing the linkage status of co-infected HIV and HCV patients" (2019). 9th Annual Rural HIV Research and Training Conference (2014-2019). 2.
https://digitalcommons.georgiasouthern.edu/ruralhiv/2019/2019/2
Analyzing the linkage status of co-infected HIV and HCV patients
Savannah, Ga.
According to the CDC, HIV/HCV co-infection triples the risk for liver failure and liver-related deaths. However, linkage to care for co-infection has been shown to be effective. We examined if our HIV and HCV co-infected patients are linked to care. Furthermore, we identified the attributes of co-infected patients and how it relates to linkage status.
