Prevalence of HIV, viral hepatitis B/C and tuberculosis and treatment outcomes among people who use drugs: Results from the implementation of the first drop-in-center in Mozambique

Baltazar, Cynthia Semá; Kellogg, Timothy A.; Boothe, Makini; Loarec, Anne; Abreu, Ernesto de; Condula, Manuel; Fazito, Erika; Raymond, Henry F.; Temmerman, Marleen; Luchters, Stanley

doi:10.1016/j.drugpo.2020.103095

Cited by 9 publications

(14 citation statements)

References 29 publications

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“…Additionally, it is consistent with a study conducted by Baltazar et al, 2021, to determine the prevalence of HIV, viral hepatitis B/C, and tuberculosis among drug users in Mozambique [25]. Their findings showed that HIV prevalence was assessed at 25.4%.…”

Section: Resultssupporting

confidence: 90%

Oxytocin level among heroin users and its correlation with personality traits and perceived childhood neglect

Dessoki

Soltan²,

Abdelrassol³

2023

Fayoum University Medical Journal

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Section: Resultssupporting

confidence: 90%

Oxytocin level among heroin users and its correlation with personality traits and perceived childhood neglect

Dessoki

Soltan²,

Abdelrassol³

2023

Fayoum University Medical Journal

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“…Like other Southern African countries, Mozambique is considered endemic for HBV [ 13 , 14 ]. Population-based studies conducted in Mozambique have reported HBV infection rates of 11.4% in prisoners [ 15 ], 13.2% in refugees [ 16 ], 4.5% to 9.3% in blood donors [ 17 , 18 ], 5.9% to 32.8% in persons who use drugs [ 19 ], 12.2% in young adults [ 13 ], 7.6% in HIV-positive adults initiating antiretroviral therapy [ 20 ], and 4.0% in pregnant women [ 21 ]. Most studies of HBV in Mozambique have been conducted in the capital city of Maputo, and information regarding viral diversity in the other regions of the country is scarce.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B virus genotypes and drug resistance mutations circulating in blood donors in Beira, Mozambique

et al. 2023

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Hepatitis B virus (HBV) infects nearly 300 million people and is the leading cause of hepatitis and hepatocellular carcinoma worldwide. Despite the high burden of HBV in sub-Saharan Africa, countries such as Mozambique have limited data available on circulating HBV genotypes and the presence of drug resistance mutations. Blood donors from Beira, Mozambique were tested for HBV surface antigen (HBsAg) and HBV DNA at the Instituto Nacional de Saúde in Maputo, Mozambique. Regardless of HBsAg status, donors with detectable HBV DNA were evaluated for HBV genotype. PCR was performed with primers amplifying a 2.1–2.2 kilobase fragment of the HBV genome. PCR products were submitted for next generation sequencing (NGS), and consensus sequences were evaluated for HBV genotype, recombination, and the presence or absence of drug resistance mutations. Of the 1281 blood donors tested, 74 had quantifiable HBV DNA. The polymerase gene could be amplified from 45 of 58 (77.6%) individuals with chronic HBV infection and 12 of 16 (75%) with occult HBV infection. Among these 57, 51 (89.5%) sequences belonged to HBV genotype A1, while 6 (10.5%) were HBV genotype E. All genotype E sequences were E/A recombinants, and clustered separately from other genotype E references. Genotype A samples had a median viral load of 637 IU/mL, while genotype E samples had a median viral load of 476,084 IU/mL. No drug resistance mutations were observed in the consensus sequences. The current study demonstrates the genotypic diversity of HBV in blood donors in Mozambique, but the absence of dominant (consensus) drug resistance mutations. Studies in other at-risk populations are essential for understanding the epidemiology, risk of liver disease, and likelihood of treatment resistance in resource-limited settings.

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“…While structural interventions seek to address the upstream factors that cause inequities, service integration and person‐centred care acknowledge these inequities and develop service packages addressing their downstream impact [ 46 ]. For example, programs among key populations have successfully integrated HIV‐related services with mental healthcare [ 47 ], gender‐affirming care [ 48 ], harm reduction [ 29 ], STI and viral hepatitis diagnosis and treatment [ 49 , 50 , 51 ], tuberculosis [ 52 ], sexual and reproductive health [ 53 ] and services that address gender‐based violence [ 54 ]. As one specific example, through EpiC Kenya, 220 key population clients who were initially reached with services to address violence (e.g.…”

Section: Discussionmentioning

confidence: 99%

Adequate funding of comprehensive community‐based programs for key populations needed now more than ever to reach and sustain HIV targets

et al. 2022

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Introduction Globally, over half of the estimated new HIV infections now occur among key populations, including men who have sex with men, sex workers, people who inject drugs, transgender individuals, and people in prisons and other closed settings, and their sexual partners. Reaching epidemic control will, for many countries, increasingly require intensified programming and targeted resource allocation to meet the needs of key populations and their sexual partners. However, insufficient funding, both in terms of overall amounts and the way the funding is spent, contributes to the systematic marginalization of key populations from needed HIV services. Discussion The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently highlighted the urgent need to take action to end inequalities, including those faced by key populations, which have only been exacerbated by the COVID‐19 pandemic. To address these inequalities and improve health outcomes, key population programs must expand the use of a trusted access platform, scale up differentiated service delivery models tailored to the needs of key populations, rollout structural interventions and ensure service integration. These critical program elements are often considered “extras,” not necessities, and consequently costing studies of key population programs systematically underestimate the total and unitary costs of services for key populations. Findings from a recent costing study from the LINKAGES project suggest that adequate funding for these four program elements can yield benefits in program performance. Despite this and other evidence, the lack of data on the true costs of these elements and the costs of failing to provide them prevents sufficient investment in these critical elements. Conclusions As nations strive to reach the 2030 UNAIDS goals, donors, governments and implementers should reconsider the true, but often hidden costs in future healthcare dollars and in lives if they fail to invest in the community‐based and community‐driven key population programs that address structural inequities. Supporting these efforts contributes to closing the remaining gaps in the 95‐95‐95 goals. The financial and opportunity cost of perpetuating inequities and missing those who must be reached in the last mile of HIV epidemic control must be considered.

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Prevalence of HIV, viral hepatitis B/C and tuberculosis and treatment outcomes among people who use drugs: Results from the implementation of the first drop-in-center in Mozambique

Cited by 9 publications

References 29 publications

Oxytocin level among heroin users and its correlation with personality traits and perceived childhood neglect

Oxytocin level among heroin users and its correlation with personality traits and perceived childhood neglect

Hepatitis B virus genotypes and drug resistance mutations circulating in blood donors in Beira, Mozambique

Adequate funding of comprehensive community‐based programs for key populations needed now more than ever to reach and sustain HIV targets

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