High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

Enkelmann, Julia; Gassowski, Martyna; Nielsen, Stine; Wenz, Benjamin; Roß, Stefan; Marcus, Ulrich; Bremer, Viviane; Zimmermann, Ruth

doi:10.1186/s12954-019-0338-y

Cited by 22 publications

(11 citation statements)

References 29 publications

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“…17 18 However, multiple barriers exist at individual, provider and system levels resulting in low rates of testing, engagement in care and completion of treatment courses for PWID. [19][20][21] Although less than 20% of PWID with chronic HCV worldwide have undergone antibody screening, the number who have completed PCR confirmatory testing is even lower. 22 Despite the introduction of highly effective direct-acting antivirals into Kenya in 2016, only a small fraction of individuals living with HCV have been treated, prompting attention to microelimination strategies.…”

Section: Open Accessmentioning

confidence: 99%

Peer-mediated HIV assisted partner services to identify and link to care HIV-positive and HCV-positive people who inject drugs: a cohort study protocol

et al. 2021

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IntroductionTargeted, tailored interventions to test high-risk individuals for HIV and hepatitis C virus (HCV) are vital to achieving HIV control and HCV microelimination in Africa. Compared with the general population, people who inject drugs (PWID) are at increased risk of HIV and HCV and are less likely to be tested or successfully treated. Assisted partner services (APS) increases HIV testing among partners of people living with HIV and improves case finding and linkage to care. We describe a study in Kenya examining whether APS can be adapted to find, test and link to HIV care the partners of HIV-positive PWID using a network of community-embedded peer educators (PEs). Our study also identifies HCV-positive partners and uses phylogenetic analysis to determine risk factors for onward transmission of both viruses.MethodsThis prospective cohort study leverages a network of PEs to identify 1000 HIV-positive PWID for enrolment as index participants. Each index completes a questionnaire and provides names and contact information of all sexual and injecting partners during the previous 3 years. PEs then use a stepwise locator protocol to engage partners in the community and bring them to study sites for enrolment, questionnaire completion and rapid HIV and HCV testing. Outcomes include number and type of partners per index who are mentioned, enrolled, tested, diagnosed with HIV and HCV and linked to care.Ethics and disseminationPotential index participants are screened for intimate partner violence (IPV) and those at high risk are not eligible to enrol. Those at medium risk are monitored for IPV following enrolment. A community advisory board engages in feedback and discussion between the community and the research team. A safety monitoring board discusses study progress and reviews data, including IPV monitoring data. Dissemination plans include presentations at quarterly Ministry of Health meetings, local and international conferences and publications.Trial registration numberNCT03447210, Pre-results stage.

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Section: Open Accessmentioning

confidence: 99%

Peer-mediated HIV assisted partner services to identify and link to care HIV-positive and HCV-positive people who inject drugs: a cohort study protocol

et al. 2021

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“…In Germany, PWID account for approximately 80% of new HCV infections with information on the mode of transmission. 27 Additionally, the number of patients who currently or previously used drugs increased from 26.3% in 2014 to 43.1% in 2018. 11 A German study of 2077 PWID showed a HCV seroprevalence of 42%-75%, that 41% of patients had chronic HCV, that 85% of the patients indicated for treatment had had a positive HCV antibody test at least once, and only 19% had been successfully treated with interferon-based therapy.…”

Section: Pwid/opioid Substitution Therapy (Ost) Patientsmentioning

confidence: 99%

Hepatitis C virus: Current steps toward elimination in Germany and barriers to reaching the 2030 goal

Sarrazin

Boesecke

Golsabahi-Broclawski³

et al. 2021

Health Science Reports

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Hepatitis C virus (HCV) affects over 70 million people globally, with an estimated 399 000 HCV‐related deaths in 2016. The World Health Organization (WHO) has set a goal to eliminate HCV by 2030. Despite the availability of direct‐acting antivirals—highly effective and well‐tolerated therapies for HCV—many patients infected with HCV in Germany have not initiated treatment, including a majority of those who are aware of their positive diagnosis. Barriers to screening, diagnosis, and treatment are major factors taking many countries off track for HCV elimination by 2030. Identifying country‐specific barriers and challenges, particularly in at‐risk populations such as people who inject drugs or men who have sex with men, has the potential to create tailored programs and strategies to increase access to screening or treatment and engage at‐risk populations. This review aims to report the current steps toward HCV elimination in Germany, the country‐specific barriers and challenges that will potentially prevent reaching the 2030 HCV elimination goal and describe good practice examples to overcome these barriers.

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“…Some communities may be better empowered than others to demand HCV self-testing. PWID represent a priority population given the high burden of HCV in this group [ 18 ], although their rights to HCV care are frequently neglected [ 19 , 20 ]. PWID participants in a qualitative study in London considered that HCV self-testing would be acceptable; however, it was also noted that barriers to accessing HCV treatment must be tackled for HCV self-testing to play a meaningful role in halting the spread of HCV among PWID [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Values and preferences for hepatitis C self-testing among people who inject drugs in Kyrgyzstan

Martínez-Pérez

Nikitin²,

Bessonova³

et al. 2021

BMC Infect Dis

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Background The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) continues to be a major public-health burden in this highly stigmatised population. To halt transmission of HCV, rapid HCV self-testing kits represent an innovative approach that could enable PWID to know their HCV status and seek treatment. As no HCV test has yet been licenced for self-administration, it is crucial to obtain knowledge around the factors that may deter or foster delivery of HCV self-testing among PWID in resource-constrained countries. Methods A qualitative study to assess values and preferences relating to HCV self-testing was conducted in mid-2020 among PWID in the Bishkek and Chui regions of Kyrgyzstan. Forty-seven PWID participated in 15 individual interviews, two group interviews (n = 12) and one participatory action-research session (n = 20). Responses were analysed using a thematic analysis approach with 4 predefined themes: awareness of HCV and current HCV testing experiences, and acceptability and service delivery preferences for HCV self-testing. Informants’ insights were analysed using a thematic analysis approach. This research received local ethics approval. Results Awareness of HCV is low and currently PWID prefer community-based HCV testing due to stigma encountered in other healthcare settings. HCV self-testing would be accepted and appreciated by PWID. Acceptability may increase if HCV self-testing: was delivered in pharmacies or by harm reduction associations; was free of charge; was oral rather than blood-based; included instructions with images and clear information on the test’s accuracy; and was distributed alongside pre- and post-testing counselling with linkage to confirmatory testing support. Conclusions HCV self-testing could increase awareness of and more frequent testing for HCV infection among PWID in Kyrgyzstan. It is recommended that peer-driven associations are involved in the delivery of any HCV self-testing. Furthermore, efforts should be maximised to end discrimination against PWID at the healthcare institutions responsible for confirmatory HCV testing and treatment provision.

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High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

Cited by 22 publications

References 29 publications

Peer-mediated HIV assisted partner services to identify and link to care HIV-positive and HCV-positive people who inject drugs: a cohort study protocol

Peer-mediated HIV assisted partner services to identify and link to care HIV-positive and HCV-positive people who inject drugs: a cohort study protocol

Hepatitis C virus: Current steps toward elimination in Germany and barriers to reaching the 2030 goal

Values and preferences for hepatitis C self-testing among people who inject drugs in Kyrgyzstan

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