Unknown

Dataset Information

0

Low adherence of HIV providers to practice guidelines for hepatocellular carcinoma screening in HIV/hepatitis B coinfection.


ABSTRACT: In the era of combination therapy for human immunodeficiency virus (HIV), liver disease, and hepatocellular carcinoma (HCC) are major causes of death for patients coinfected with HIV and hepatitis B virus (HBV). This study compared HIV provider and hepatologist awareness of and adherence to the American Association for the Study of Liver Diseases (AASLD) practice guidelines for chronic HBV management. The primary endpoint of HIV provider adherence to HCC screening recommendations was compared to that of hepatologists at a large metropolitan academic medical center.Medical record database searches by ICD-9 codes were used to identify HIV/HBV coinfected (n = 144) and HBV monoinfected (n = 225) patients who were seen at least twice over a 2-year period in outpatient clinics. Adherence to AASLD guidelines was assessed by chart review. Provider awareness was evaluated through a voluntary anonymous survey with knowledge-based questions.Over a 2-year period, only 36.0% of HIV/HBV coinfected patients seen in HIV practices completed HCC screening compared to 81.8% of HBV monoinfected patients in hepatology practices (P < .00001). Similarly, HIV providers less frequently monitored HBV viral load (P < .0001), HBeAg/anti-HBe (P < .00001), HBsAg/anti-HBs (P < .00001) than hepatologists but screened more often for hepatitis A immunity (P = .028). Self-reported adherence and knowledge scores were similar among 19 HIV providers and 16 hepatologists.HIV providers ordered significantly fewer HCC screening and HBV monitoring tests than hepatologists within a single academic medical center. In the setting of increased reliance on quality indicators for care, both patients and providers will benefit from greater adherence to established guidelines.

SUBMITTER: Hearn B 

PROVIDER: S-EPMC4809983 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

altmetric image

Publications

Low adherence of HIV providers to practice guidelines for hepatocellular carcinoma screening in HIV/hepatitis B coinfection.

Hearn Bevin B   Chasan Rachel R   Bichoupan Kian K   Suprun Maria M   Bagiella Emilia E   Dieterich Douglas T DT   Perumalswami Ponni P   Branch Andrea D AD   Huprikar Shirish S  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20150803 11


<h4>Background</h4>In the era of combination therapy for human immunodeficiency virus (HIV), liver disease, and hepatocellular carcinoma (HCC) are major causes of death for patients coinfected with HIV and hepatitis B virus (HBV). This study compared HIV provider and hepatologist awareness of and adherence to the American Association for the Study of Liver Diseases (AASLD) practice guidelines for chronic HBV management. The primary endpoint of HIV provider adherence to HCC screening recommendati  ...[more]

Similar Datasets

| S-EPMC5257196 | biostudies-literature
| S-EPMC2953468 | biostudies-literature
| S-EPMC8448304 | biostudies-literature
| S-EPMC4334674 | biostudies-literature
| S-EPMC3511890 | biostudies-literature
| S-EPMC2359164 | biostudies-other
| S-EPMC5661989 | biostudies-literature
| S-EPMC10716733 | biostudies-literature
| S-EPMC4825161 | biostudies-literature
| S-EPMC4099340 | biostudies-literature