Hepatitis C virus testing, liver disease assessment and treatment uptake among people who inject drugs pre- and post-universal access to direct-acting antiviral treatment in Australia: The LiveRLife study.
Adolescent
Adult
Antiviral Agents
/ therapeutic use
Australia
/ epidemiology
Cohort Studies
Drug Users
/ statistics & numerical data
Female
Health Services Accessibility
Hepacivirus
/ genetics
Hepatitis C
/ diagnosis
Humans
Liver Diseases
/ diagnosis
Male
Middle Aged
Patient Acceptance of Health Care
Substance Abuse, Intravenous
/ complications
Young Adult
cascade of care
direct-acting antiviral
hepatitis C virus
linkage to care
treatment uptake
Journal
Journal of viral hepatitis
ISSN: 1365-2893
Titre abrégé: J Viral Hepat
Pays: England
ID NLM: 9435672
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
03
05
2019
revised:
04
09
2019
accepted:
07
10
2019
pubmed:
8
11
2019
medline:
26
3
2021
entrez:
8
11
2019
Statut:
ppublish
Résumé
Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treatment uptake among people who inject drugs (PWID) persist. We aimed to describe the cascade of HCV care among PWID in Australia, prior to and following unrestricted access to direct-acting antiviral (DAA) treatment. Participants enrolled in an observational cohort study between 2014 and 2018 provided fingerstick whole-blood samples for dried blood spot, Xpert HCV Viral Load and venepuncture samples. Participants underwent transient elastography and clinical assessment by a nurse or general practitioner. Among 839 participants (mean age 43 years), 66% were male (n = 550), 64% (n = 537) injected drugs in the previous month, and 67% (n = 560) reported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had detectable HCV RNA, of whom 23% (n = 86) received HCV treatment within 12 months of enrolment. HCV treatment uptake increased from 2% in the pre-DAA era to 38% in the DAA era. Significant liver fibrosis (F2-F4) was more common in participants with HCV infection (38%) than those without (19%). Age 50 years or older (aOR, 2.88; 95% CI, 1.18-7.04) and attending a clinical follow-up with nurse (aOR, 3.19; 95% CI, 1.61-6.32) or physician (aOR, 11.83; 95% CI, 4.89-28.59) were associated with HCV treatment uptake. Recent injection drug use and unstable housing were not associated with HCV treatment uptake. HCV treatment uptake among PWID has increased markedly in the DAA era. Evaluation of innovative and simplified models of care is required to further enhance treatment uptake.
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
281-293Investigateurs
Lucy Peolim
(L)
Dianne How-Chow
(D)
Jo Telenta
(J)
Paul Harvey
(P)
Sandra Jones
(S)
Adrian Dunlop
(A)
Carla Treloar
(C)
Yvonne Samuel
(Y)
Fiona Poeder
(F)
Sione Crawford
(S)
Alicia Baxter
(A)
Julian Keats
(J)
Yasmin Mowat
(Y)
David Silk
(D)
Michelle Micallef
(M)
Mahshid Tamaddoni
(M)
Pip Marks
(P)
Francois Lamoury
(F)
Indika Jayasinghe
(I)
Hannah Reid
(H)
Evan B Cunningham
(EB)
Sofia Bartlett
(S)
Brendan Jacka
(B)
Amanda Erratt
(A)
Marianne Jauncey
(M)
Patricia Collie
(P)
Thao Lam
(T)
Rosemary Gilliver
(R)
Susan Hazelwood
(S)
Nives Houlihan
(N)
Carina Burns
(C)
Rhondda Lewis
(R)
Daniel Morris
(D)
Kathy Donohue
(K)
Astrid Carthew
(A)
Nadine Horasak
(N)
Robert Cherry
(R)
Sue Shin
(S)
Deborah Peterson
(D)
Todd Sellwood
(T)
Wade McKeown
(W)
Janice Pritchard-Jones
(J)
Fionnualh Smyth
(F)
Sara Adey
(S)
Kathy Clark
(K)
Informations de copyright
© 2019 John Wiley & Sons Ltd.
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