HIV Serostatus and Having Access to a Physician for Regular Hepatitis C Virus Care Among People Who Inject Drugs

Beaulieu, Tara; Hayashi, Kanna; Milloy, M.‐J.; Nosova, Ekaterina; DeBeck, Kora; Montaner, Julio S. G.; Ti, Lianping

doi:10.1097/qai.0000000000001651

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…It is thus not surprising that having a primary care provider was associated with HCV treatment. The finding of an association of HCV treatment with HIV infection is also likely driven by federal and local policies and funding that prioritize HIV treatment and prevention, which increases the likelihood of PWID living with HIV being engaged in any healthcare and receiving HCV treatment, as compared to HIV‐uninfected PWID 27,34,35 . Additionally, because HIV and HCV co‐infection is associated with an increased risk of accelerated progression to hepatocellular cancer and liver failure, 36‐38 HCV treatment has been prioritized among people living with HIV.…”

Section: Discussionmentioning

confidence: 99%

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

Falade‐Nwulia

Gicquelais

Astemborski

et al. 2020

Liver International

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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

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Section: Discussionmentioning

confidence: 99%

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

Falade‐Nwulia

Gicquelais

Astemborski

et al. 2020

Liver International

View full text Add to dashboard Cite

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“…For HCV/HIV-coinfected patients receiving HIV primary care, HIV services present a setting to engage them in HCV care. Indeed, a recent study assessing access to HCV care among injection drug users found that those who were HIV-infected were more likely to receive HCV care due to engaging in HIV care 46. Inasmuch as the emerging sexual HCV transmission among HIV-infected MSM, HCV-related education and support services should target this high-risk group,47 48 and DAA treatment should be considered for coinfected MSM as a strategy of ‘treatment-as-prevention’ 49.…”

Section: Discussionmentioning

confidence: 99%

Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

et al. 2019

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ObjectivesLittle is known about the cascade of hepatitis C care among HIV/hepatitis C virus (HCV)-coinfected patients in community-based clinics. Thus, we analysed our data from the interferon era to understand the barriers to HCV treatment, which may help improve getting patients into treatment in the direct-acting antivirals era.DesignRetrospective cohort study.SettingFour HIV clinics of a multisite community health centre in the USA.Participants1935 HIV-infected men with >1 medical visit to the clinic between 2011 and 2013. Of them, 371 had chronic HCV and were included in the analysis for HCV care continuum during 2003–2014.Outcome measuresHCV treatment initiation was designated as the primary outcome for analysis. Multivariate logistic regression was performed to identify factors associated with HCV treatment initiation.ResultsAmong the 371 coinfected men, 57 (15%) initiated HCV treatment. Entering care before 2008 (adjusted OR [aOR, 3.89; 95% CI, 1.95 to 7.78), higher educational attainment (aOR, 3.20; 95% CI, 1.59 to 6.44), HCV genotype 1 versus non-1 (aOR, 0.21; 95% CI, 0.07 to 0.65) and HIV suppression (aOR, 2.13; 95% CI, 1.12 to 4.06) independently predicted treatment initiation. Stratification by entering care before or after 2008 demonstrated that higher educational attainment was the only factor independently associated with treatment uptake in both periods (aOR, 2.79; 95% CI, 1.13 to 6.88 and aOR, 4.10; 95% CI, 1.34 to 12.50, pre- and post-2008, respectively). Additional associated factors in those entering before 2008 included HCV genotype 1 versus non-1 (aOR, 0.09; 95% CI, 0.01 to 0.54) and HIV suppression (aOR, 2.35; 95% CI, 1.04 to 5.33).ConclusionsSome traditional barriers predicted HCV treatment initiation in those in care before 2008; however, the patients’ level of educational attainment remained an important factor even towards the end of the interferon era. Further studies will need to determine whether educational attainment persists as an important determinant for initiating direct-acting antiviral therapies.

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“…Programmes (n=10) incorporated infectious disease treatment with addictions treatment or other services, such as counselling. [78][79][80][81][82][83][84][85][86][87] Studies were conducted in Vancouver, BC (n=7), 78 79 81-83 87 Montreal, QC (n=2), 80 84 and Kingston, ON (n=1). 86 Programmes were community based (n=2), 83 84 in established community health centres (n=4), 81 85-87 offered through multiple sites (n=3) [78][79][80] or not specified (n=1).…”

Section: Integrated Infectious Disease and Addictions Servicesmentioning

confidence: 99%

“…[78][79][80][81][82][83][84][85][86][87] Studies were conducted in Vancouver, BC (n=7), 78 79 81-83 87 Montreal, QC (n=2), 80 84 and Kingston, ON (n=1). 86 Programmes were community based (n=2), 83 84 in established community health centres (n=4), 81 85-87 offered through multiple sites (n=3) [78][79][80] or not specified (n=1). 82 Studies addressed HIV (n=3), 81 82 85 HCV (n=5), 79 80 84 86 87 or HIV and HCV (n=2).…”

Section: Integrated Infectious Disease and Addictions Servicesmentioning

confidence: 99%

Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

et al. 2021

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ObjectivesPeople who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.DesignThis study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.ResultsThis study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.ConclusionsThese results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.PROSPERO registration numberCRD42020142947.

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HIV Serostatus and Having Access to a Physician for Regular Hepatitis C Virus Care Among People Who Inject Drugs

Cited by 7 publications

References 33 publications

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

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

Trends in hepatitis C treatment initiation among HIV/hepatitis C virus-coinfected men engaged in primary care in a multisite community health centre in Maryland: a retrospective cohort study

Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

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