? The care of chronic hepatitis C (HCV) infection among drug users, many of whom are co-infected with HIV, is an important public health problem. For drug users with chronic HCV infection, alcohol and active drug abuse, high rates of depression, susceptibility to hepatitis A and B infections, and HIV co-infection are only a few of the variables that affect engagement in and outcome of HCV chemotherapy. Attention to these """"""""pre-chemotherapeutic"""""""" factors prepares drug users for future and possibly more efficacious HCV chemotherapy. However, little is known about whether these """"""""pre-chemotherapeutic"""""""" factors are successfully addressed in the context of chronic HCV management. ? ? The candidate proposes the following specific aims: ? 1) To determine rates of engagement in pre-chemotherapeutic care among drug users with chronic HCV infection. ? 2) To determine factors associated with awareness and acceptance of interventions other than specific chemotherapy for reducing the progression of chronic HCV infection and preparing for future chemotherapy. ? ? The candidate proposes a five-year prospective study of engagement in and factors associated with pre-chemotherapeutic care for hepatitis C infection, among HCV-infected drug users participating in two ongoing cohort studies of men and women with or at risk for HIV. Participants will be screened and enrolled at a semi-annual research visit for the parent studies. At each semi-annual research visit, study participants will undergo standardized interviews to gather data on demographics, sexual and drug-using behaviors and medical history, including symptoms of and treatment for hepatitis. In addition, blood will be drawn for laboratory assays including HCV antibody and HCV RNA levels. ? ? The purpose of this K23 grant proposal is to support this candidate as she develops her clinical research career and undertakes studies in HCV-infected drug users with or at risk for HIV, under the mentorship of experienced investigators. ? ? ? ?
| Felsen, Uriel R; Fishbein, Dawn A; Litwin, Alain H (2010) Low rates of hepatitis A and B vaccination in patients with chronic hepatitis C at an urban methadone maintenance program. J Addict Dis 29:461-5 |
| Chasan, Rachel; Reese, Lindsey; Fishbein, Dawn (2010) HIV and Hepatitis B Virus Coinfection: Approach to Management: Case Study and Commentary. J Clin Outcomes Manag 17:273-286 |
| Weiss, Jeffrey J; Osorio, Georgina; Ryan, Elizabeth et al. (2010) Prevalence and patient awareness of medical comorbidities in an urban AIDS clinic. AIDS Patient Care STDS 24:39-48 |
| Weiss, J J; Bräu, N; Stivala, A et al. (2009) Review article: adherence to medication for chronic hepatitis C - building on the model of human immunodeficiency virus antiretroviral adherence research. Aliment Pharmacol Ther 30:14-27 |
