362. Hepatitis C Virus (HCV) Co-Infection in Women Living with Human Immunodeficiency Virus (HIV) in Northwest Louisiana

Abstract

BackgroundHIV and HCV infection are emerging global public health problems. People living with untreated HIV infection have higher HCV viral loads and more rapid HCV disease progression with twice the rates of perinatal HCV transmission. Data are lacking in HCV coinfected women living with HIV. Our study reviewed underrepresented minority group of women living with HIV/HCV in Northwestern Louisiana to better understand epidemiology, risk factors and access to care among this cohort.MethodsWomen with HIV/HCV coinfection aged 18–70 years who presented to an academic medical center between November 2011 and November 2018 were included for analysis. A retrospective chart review was conducted. Data were collected and analyzed on demographics (age, race), risk factors (sexual history, drug use), HIV (viral load, CD4 count, antiretroviral treatment (ART)), and HCV (viral load level and antibody, genotype, alanine transaminase, liver fibrosis, liver cirrhosis, referral, and treatment).ResultsA total of 41 patients met our inclusion criteria. The mean age was 52 years. Of these HIV/ HCV coinfected women, 27 (66%) were African American and 14 (34%) Caucasian. 18 (44%) had history of Injection drug use. Thirty-nine out of 41 (95%) were linked to HIV care and on antiretroviral therapy with 36 (88%) with CD4 count >200. Twenty-three out of 41 (56%) was referred for HCV treatment but only 11 (26%) co-infected patients received treatment for HCV.ConclusionIn this cohort of HCV/HIV coinfected women, only 26% of the women received HCV treatment. Some of the barriers include access to providers, linkage to care and behavioral and socioeconomic factors. The lack of timely appropriate HCV care in this underserved high-risk population is alarming especially in the current era of highly effective direct-acting antiviral therapy for HCV. Despite improved HIV care, further work needs to focus on optimizing HCV screening, linkage and treatment uptake in order to overcome multiple barriers to HCV elimination in this patient population.Disclosures All authors: No reported disclosures.