Insights on the Russian HCV care cascade: minimal HCV treatment for HIV/HCV co-infected PWID in St. Petersburg

Abstract

BackgroundThe human immunodeficiency virus (HIV) epidemic in Russia, driven by injection drug use, has seen a steady rise in the past two decades. Hepatitis C virus (HCV) infection is highly prevalent in people who inject drugs (PWID). The study aimed to describe the current frequency of HCV testing and treatment among HIV-infected PWID in St. Petersburg, Russia.MethodsThis study examined baseline data from the “Linking Infectious and Narcology Care” (LINC) and “Russia Alcohol Research Collaboration on HIV/AIDS” (Russia ARCH) studies. Participants included in this analysis were HIV-infected with a history of injection drug use. Descriptive statistics were performed to assess frequency of HCV testing and treatment.ResultsParticipants (n = 349 [LINC], 207 [Russia ARCH]) had a mean age of 33.8 years (IQR: 31–37) in LINC and 33.0 (IQR: 30–36) in Russia ARCH; 26.6 % (LINC) and 29.0 % (Russia ARCH) were female; 100 % were Caucasian. Nearly all participants had been tested for HCV (98.9 % in LINC, 97.1 % in Russia ARCH). Almost all reported being diagnosed HCV positive (98.9 % in LINC, 97.1 % in Russia ARCH). Only 2.3 % of LINC and 5.0 % of Russia ARCH participants reported ever receiving HCV treatment.ConclusionsAmong these cohorts of HIV-infected PWID in St. Petersburg, Russia, as of 2015 nearly all reported being tested for HCV and testing positive, while only 3.3 % received any HCV treatment. In this new era of effective HCV pharmacotherapy, an enormous chasm in the HCV treatment cascade in Russia exists providing substantial opportunities for curing HCV in HIV-infected Russians with a history of injection drug use.Trial registrationThe studies described were registered with ClinicalTrials.gov through the National Institutes of Health: Linking Infectious and Narcology Care in Russia (LINC) - NCT01612455, registered 1 June 2012, first participant enrolled 3 July 2012; Alcohol’s Impact on Inflammatory Markers in HIV Disease - Russia ARCH Cohort - NCT01614626, registered 25 May 2012, first participant enrolled 15 November 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s41124-016-0020-x) contains supplementary material, which is available to authorized users.

Establishing a hepatitis C continuum of care among HIV/hepatitis C virus‐coinfected individuals in EuroSIDA

“…A CoC can also be used to identify leaks/breaks in HCV care that need to be addressed in order to ensure individuals’ transition through all stages and achievement of SVR. Several different HCV care continuums have been proposed for both HCV‐monoinfected and HIV/HCV‐coinfected individuals . While none of the steps in the HCV continuum of care are unique to HIV/HCV‐coinfected individuals, the optimal design of a CoC might be different for coinfected individuals already linked to specialist HIV care.…”

“…While none of the steps in the HCV continuum of care are unique to HIV/HCV‐coinfected individuals, the optimal design of a CoC might be different for coinfected individuals already linked to specialist HIV care. However, proposed continuums for coinfected individuals use diverse methodology . More work is therefore required to develop a standardized CoC for HCV‐infected people living with HIV.…”

Alcohol Use Disorder and Hepatitis C Prevention and Care in People Who Inject Drugs: The State of Play

“…at-risk populations, especially in eastern European countries, such as Russia. 57 Expanding access to HCV treatment even among marginalized PWID will have both public health and social benefits. 9,58 Engaging primary care providers/general practitioners in the screening, follow-up, and treatment of HCV infection can extend access to HCV care.…”

<p>Elbasvir/Grazoprevir for HCV Infection in Russia: A Randomized Trial</p>

“…5,6 Despite the high prevalence and clear unmet healthcare need, the proportion of HCV-infected Russian individuals accessing treatment for HCV infection remains very low. 7 Oral direct-acting antiviral therapies currently available in Russia are simeprevir, sofosbuvir, glecaprevir/pibrentasvir, paritaprevir/ombitasvir/ritonavir with or without dasabuvir, and elbasvir/grazoprevir. 8 However, of the~5 million HCV-infected individuals in Russia, it is estimated that only 35,000 have currently received direct-acting antiviral therapy, possibly owing to a lack of widespread screening programs and poor access to treatment.…”