Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management.
Hepatitis C virus
addiction and dual diagnosis center
direct-acting antiviral agents
dual diagnosis
substance use disorder
Journal
Therapeutic advances in gastroenterology
ISSN: 1756-283X
Titre abrégé: Therap Adv Gastroenterol
Pays: England
ID NLM: 101478893
Informations de publication
Date de publication:
2021
2021
Historique:
received:
11
12
2020
accepted:
13
04
2021
entrez:
2
9
2021
pubmed:
3
9
2021
medline:
3
9
2021
Statut:
epublish
Résumé
Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis). This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients' consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed. 528 individuals attended the center (November 2018-June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis).
METHODS
METHODS
This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients' consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed.
RESULTS
RESULTS
528 individuals attended the center (November 2018-June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence
CONCLUSION
CONCLUSIONS
This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.
Identifiants
pubmed: 34471422
doi: 10.1177/17562848211016563
pii: 10.1177_17562848211016563
pmc: PMC8404622
doi:
Types de publication
Journal Article
Langues
eng
Pagination
17562848211016563Informations de copyright
© The Author(s), 2021.
Déclaration de conflit d'intérêts
Conflict of interest statement: Lara Grau-López: No personal or financial conflicts of interest. Cristina Marcos-Fosch: No personal or financial conflicts of interest. Constanza Daigre: No personal or financial conflicts of interest. Raúl Felipe Palma-Alvarez: No personal or financial conflicts of interest. Ariadna Rando-Segura: No personal or financial conflicts of interest. Jordi Llaneras: No personal or financial conflicts of interest. Marta Perea-Ortueta: No personal or financial conflicts of interest. Francisco Rodriguez-Frias: No personal or financial conflicts of interest. Nieves Martínez-Luna: No personal or financial conflicts of interest. Mar Riveiro-Barciela: Has received research grants from Gilead, and served as speaker for Gilead and Grifols. No personal conflicts of interest. Josep Antoni Ramos-Quiroga: No personal or financial conflicts of interest. Joan Colom: No personal or financial conflicts of interest. Rafael Esteban: Has received research grants from Gilead and has served as advisor for Gilead, Bristol-Myers Squibb, and Novartis. No personal conflicts of interest. María Buti: Has received research grants from Gilead and has served as advisor for Gilead, Bristol-Myers Squibb, and Novartis. No personal conflicts of interest.
Références
Liver Int. 2019 Oct;39(10):1845-1851
pubmed: 31169953
J Subst Abuse Treat. 2009 Jan;36(1):75-86
pubmed: 18657940
Gastroenterology. 2002 Aug;123(2):476-82
pubmed: 12145801
Addict Behav. 2016 Jul;58:104-9
pubmed: 26922157
Eur J Public Health. 2010 Apr;20(2):139-45
pubmed: 19564240
Eur J Gastroenterol Hepatol. 2017 Jun;29(6):629-633
pubmed: 28230562
Epidemiology. 2017 Nov;28(6):872-879
pubmed: 28731961
Drug Alcohol Depend. 2001 Mar 1;62(1):9-17
pubmed: 11173163
Am J Psychiatry. 2003 May;160(5):890-5
pubmed: 12727692
Nat Rev Dis Primers. 2017 Mar 02;3:17006
pubmed: 28252637
J Infect Dis. 2018 May 25;217(12):1889-1896
pubmed: 29534185
Int J Drug Policy. 2015 Oct;26(10):893-8
pubmed: 26254497
Subst Abus. 2014;35(2):133-40
pubmed: 24821349
Arch Gen Psychiatry. 1961 Jun;4:561-71
pubmed: 13688369
Lancet Gastroenterol Hepatol. 2017 May;2(5):325-336
pubmed: 28397696
J Hepatol. 2018 Aug;69(2):461-511
pubmed: 29650333
Hepat Med. 2018 Dec 24;11:1-11
pubmed: 30613166
J Infect Chemother. 2020 Jan;26(1):18-22
pubmed: 31301972
World J Gastroenterol. 2020 Oct 14;26(38):5874-5883
pubmed: 33132641
Subst Use Misuse. 2001 Mar;36(4):523-34
pubmed: 11346280
Addict Behav. 2004 Dec;29(9):1875-82
pubmed: 15530732
Public Health Rep. 2016 May-Jun;131 Suppl 2:74-83
pubmed: 27168665
Am J Public Health. 2001 Jan;91(1):31-7
pubmed: 11189820
J Psychoactive Drugs. 2017 Sep-Oct;49(4):306-315
pubmed: 28682218
Drug Alcohol Depend. 2011 Jan 15;113(2-3):147-56
pubmed: 20801586
Am J Public Health. 2007 Oct;97(10):1790-3
pubmed: 17761572
Int J Drug Policy. 2019 Dec;74:236-245
pubmed: 31706159
Addiction. 2018 May;113(5):868-882
pubmed: 29359361