Primary care takes on HIV and its co-infections
With limited access to specialty care, HIV patients are seeking treatment from primary care physicians for management of HIV and co-infections.
Human immunodeficiency virus (HIV) isn’t the only disease moving out of specialty care and into the primary care office. Primary care physicians are now taking on more areas of co-infection, such as hepatitis C (HCV), out of necessity.
With limited access to specialists a problem for many patients, researchers at the University of Maryland conducted a study to determine whether primary care providers could fill the gap.
HCV treatment led by PCPs and nurse practitioners was equally effective and safe as care by experienced specialists. In fact, the study showed that composite adherence to a 12-week treatment regimen was significantly higher in primary practices, with 50% adherence with nurse practitioner practices, 41% in PCP practices, and 19% in specialty practices.
Additional details about the study will be presented under the title,
Medical Economics: What is the role of PCPs in treating HIV patients co-infected with HCV?
Kattakuzhy: In the era of direct-acting antiviral therapy, HIV co-infection no longer impacts treatment efficacy. As such, similar to patients with HCV mono-infection, co-infected patients with stable HIV disease can be treated safely and successfully by primary care providers. One important factor in treating HIV/HCV co-infected patients is recognition of drug-drug interactions, but outside of this, treatment is generally the same as patients with HCV mono-infection. Patients with decompensated cirrhosis, including both HCV-mono or HIV/HCV co-infected patients, should be evaluated by specialist providers with experience in advanced liver disease and transplantation.
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