Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

Goutzamanis, Stelliana; Doyle, Joseph S; Higgs, Peter; Hellard, Margaret

doi:10.1111/jvh.13020

Cited by 12 publications

(11 citation statements)

References 74 publications

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“…HCV infection is a public health concern, with over 185 million people infected around the world. About 1.8% of the United States population is positive for the antibody to HCV, with 74% chronically infected, of which, 25-35% will progress to liver cirrhosis associated with an estimated 8,000-10,000 deaths every year [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Gayam

Jegede

Tiongson

et al. 2019

Dig Dis

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Background: The highest burden of hepatitis C virus (HCV) infection is seen in patients with psychiatric disorders who have been excluded from traditional treatments with Interferon due to treatment-emergent neuropsychiatric adverse effects. The goal of this study is to determine the tolerability, treatment retention, and efficacy of direct-acting antivirals with psychiatric disorders and comorbid substance use disorders in real-life settings. Methods: This is a retrospective cohort observational study of HCV patients treated with direct-acting antivirals between January 2016 and December 2018. Patients were stratified and sub-stratified based on their psychiatric diagnosis and substance use. The primary assessment was the sustained virologic response at 12 weeks post-treatment (SVR12). Results: Among the 291 patients analyzed, patients with psychiatric diagnosis and non-psychiatric patients made up 51.2% (n = 149) and 48.8% (n = 142) respectively. Majority of the patients included in the study were African-Americans (68.7%, n = 200). Overall, 95.3% (142/149) and 94.4% (134/142) of psychiatric and nonpsychiatric patients, respectively, achieved SVR12 and treatment response was similar between the groups (p = 0.72). Among psychiatric patients, only the prior treatment status was identified as a predictor of treatment response (OR 0.153, 95% CI 0.03-0.79; p = 0.05). No statistical difference was observed among the patients with SVR12 based on their primary psychiatric diagnoses or by comorbid substance abuse. Conclusion: The results of our study show that directacting antiviral treatments are well tolerated in psychiatric patients, and an overwhelming majority of patients achieved SVR12. Our study highlights the need to integrate HCV screening with treatment linkage in psychiatry and primary care practice.

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Section: Introductionmentioning

confidence: 99%

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Gayam

Jegede

Tiongson

et al. 2019

Dig Dis

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“…13 Lack of awareness of HCV status or available services, low perceived risk, or fear of HCV-related stigma and discrimination deter people from seeking HCV care, while time constraints and lack of specific HCV knowledge prevent providers from offering HCV care. [14][15][16][17] Madden et al 18 previously categorised reported barriers to HCV treatment as broadly based on personal, provider and system-level barriers. 18 An individual may be disinclined to access HCV treatment due to being asymptomatic (personal barrier), while also unable to receive treatment from their usual doctor (provider barrier) and further worried about experiencing stigma from a new provider (system-level barrier).…”

Section: Open Accessmentioning

confidence: 99%

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

et al. 2022

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IntroductionThe advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care.Methods and analysisThe EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time.Ethics and disseminationEthical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.

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“…However, there are limited data on PREs with DAA therapy among vulnerable populations. 4 In this study, we aimed to assess PREs in patients experiencing homelessness during HCV daa therapy in an integrated homeless shelter-based model of HCV care that was implemented following assessment of key stakeholders' perspectives. 2,5 1) associated with PREs were evaluated using univariable and multivariable logistic regression models.…”

Section: Introductionmentioning

confidence: 99%

Patient‐reported experiences with direct acting antiviral therapy in an integrated model of hepatitis C care in homeless shelters

Kim

Powell

Naugle

et al. 2021

Journal of Viral Hepatitis

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Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

Cited by 12 publications

References 74 publications

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

Patient‐reported experiences with direct acting antiviral therapy in an integrated model of hepatitis C care in homeless shelters

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