Hepatitis C treatment uptake among people who inject drugs in the oral direct‐acting antiviral era

Abstract

Background: Increased uptake of hepatitis C virus (HCV) treatment among people who inject drugs (PWID) will be critical to achieve HCV elimination goals. There are limited data on HCV treatment uptake among PWID recruited from communitybased settings in the HCV direct-acting antiviral (DAA) era. Methods: We analysed data from PWID with HCV newly recruited into the Baltimore, Maryland-based AIDS Linked to the IntraVenous Experience (ALIVE) cohort between 2015 and 2018. We characterized the HCV care continuum and evaluated factors associated with HCV treatment uptake. Results: Of the 418 PWID with HCV, the median age was 49 years and most (88%) reported recent injection drug use (IDU). Overall, 23% had ever been evaluated by a provider for HCV treatment, 17% ever initiated DAA treatment and 13% were cured of HCV infection. Treatment uptake approximately doubled between 2015 and 2018 (13% to 26%, P = .01). In multivariable analyses, HIV infection (adjusted Odds Ratio [aOR] 2.5 [95% Confidence Interval (CI) 1.3, 4.8]), current employment (aOR 4.1 [CI 1.2, 14.4]), having a primary care provider (aOR 4.3 [CI 1.2, 14.9

Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID

“…The rate of uptake of antiviral treatment among PWID before the DAA era was reported to be low, probably due to poor tolerability and lack of efficacy, 22,23 although it is increasing with DAA treatment in the United States. 24 In contrast, our study showed that the overall treatment rate was higher among PWID than among non-PWID, especially in the pre-DAA era. In the pre-DAA era, old age and E p u b a h e a d o f p r i n t comorbidities might have deterred interferon-based therapy, so that the PWID group with younger age and less comorbidities treated more than the non-PWID group.…”

“…The rate of uptake of antiviral treatment among PWID before the DAA era was reported to be low, probably due to poor tolerability and lack of efficacy [ 22 , 23 ], although it has increased with DAA treatment in the United States [ 24 ]. In contrast, our study showed that the overall treatment rate was higher among PWID than among non-PWID, especially in the pre-DAA era.…”

Umsetzung von Testung, Diagnostik und Behandlung der Hepatitis C in Einrichtungen der niedrigschwelligen Drogenhilfe in Deutschland – eine Querschnittsbefragung

“…Internationale Studien zeigen, dass z. B. innovative Rekrutierungsstrategien mit geschulten Peers [26], Belohnungsanreize [27] oder Versorgungsmodelle mit integrierter Testung, Diagnose und Versorgung [28] geeignet sein können, um die Inanspruchnahme von HCV-Test-und -Behandlungsangeboten bei Menschen mit injizierendem und anderen Drogenkonsumformen zu erhöhen.…”

Substance use disorder treatment providers’ knowledge and opinions toward testing and treatment of chronic hepatitis C in rural North Carolina.

“…, 2020). Models of integrated care delivery for opioid use disorders (OUPs), HCV, and HIV are being studied and early results find high acceptance for colocated care among practitioners (Falade-Nwulia et al, 2020;Rich et al, 2018).…”

“…Using approaches modeled on Extension for Community Healthcare Outcomes (Project ECHO), academic medical centers have trained and coached rural primary care providers to prescribe HCV treatment in rural areas (North Carolina Carolina Hepatitis Academic Mentorship Program [CHAMP] Program, 2020). Models of integrated care delivery for opioid use disorders (OUPs), HCV, and HIV are being studied and early results find high acceptance for colocated care among practitioners (Falade-Nwulia et al, 2020; Rich et al, 2018). Recently, a large, national randomized, pragmatic trial showed that PWID could be successfully cured of HCV when treatment was delivered in opioid treatment clinics and community health centers (Litwin, Jost, et al, 2019).…”