Patient‐reported outcomes of the Treatment and Prevention Study: A real‐world community‐based trial of direct‐acting antivirals for hepatitis C among people who inject drugs

Goutzamanis, Stelliana; Spelman, Timothy; Harney, Brendan; Dietze, Paul; Stoové, Mark; Higgs, Peter; Thompson, Alexander; Doyle, Joseph; Hellard, Margaret

doi:10.1111/jvh.13516

Cited by 9 publications

(10 citation statements)

References 39 publications

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“…This cross-sectional retrospective cohort study conducted in 2020 included plasma samples and demographic and clinical data from adults over 18 years with chronic liver disease and healthy controls sourced from several Australian clinical trial cohorts and biobanks, including CATCH study, 22 STOP study, 23 TAP study, 24 Austin Hospital cirrhosis study, Royal Prince Alfred Hospital Liver Biobank, St Vincent’s Hospital Liver Biobank and Burnet Institute COVID-19 study (Supplemental Table S1, http://links.lww.com/HC9/A225 ). Samples and data were collected during the preceding 5 years (Austin cirrhosis cohort collected within 10 y) of the study.…”

Section: Methodsmentioning

confidence: 99%

A novel point-of-care test for cirrhosis based on dimeric to monomeric IgA ratio in blood: a pilot cohort study

Howell

Van

Pham

et al. 2023

Hepatology Communications

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Background and Aims: Dimeric IgA to monomeric IgA ratio (dIgA ratio) is a biomarker of gut mucosal leakage in liver cirrhosis. We evaluated the diagnostic performance of a novel point-of-care (POC) dIgA ratio test for cirrhosis. Methods: Plasma samples from people with chronic liver disease were analyzed using the BioPoint POC dIgA ratio antigen immunoassay lateral flow test. Cirrhosis was defined by Fibroscan>12.5 kPa, clinical evidence of cirrhosis or liver histopathology. POC dIgA test diagnostic accuracy was determined in a test cohort using receiver operating characteristic curve analysis; optimal cutoffs for sensitivity and specificity were then applied to a validation cohort. Results: A total of 1478 plasma samples from 866 patients with chronic liver disease were included (test cohort n = 260, validation cohort n = 606). In all, 32% had cirrhosis; 44% Child-Pugh A, 26% Child-Pugh B, and 29% Child-Pugh C. Median POC dIgA ratio was higher in cirrhosis (0.9) compared with no cirrhosis (0.4, p < 0.001), and in Child-Pugh class B/C compared with A cirrhosis (1.4 Child-Pugh B/C vs. 0.6 Child-Pugh A, p < 0.001). POC dIgA ratio test had good diagnostic accuracy for liver cirrhosis in the test cohort (area under the receiver operating characteristic curve=0.80); a dIgA ratio cutoff of 0.6 had a sensitivity of 74% and specificity of 86%. POC dIgA test accuracy was moderate in the validation cohort (area under the receiver operating characteristic curve=0.75; positive predictive value 64%, negative predictive value 83%). Using a dual cutoff approach, 79% of cirrhosis cases were correctly diagnosed and further testing was avoided in 57%. Conclusions: POC dIgA ratio test had moderate accuracy for cirrhosis. Further studies evaluating the accuracy of POC dIgA ratio testing for cirrhosis screening are warranted.

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Section: Methodsmentioning

confidence: 99%

A novel point-of-care test for cirrhosis based on dimeric to monomeric IgA ratio in blood: a pilot cohort study

Howell

Van

Pham

et al. 2023

Hepatology Communications

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“…In order to recruit participants from diverse backgrounds and familiarly with research, participants were recruited from two different sources. First, the Treatment and Prevention (TAP) Study, a nurse-led community-based DAA treatment trial, assessing the feasibility of treating people who inject drugs and their injecting networks (clinicaltrials.gov identifier; NCT023363517) [ 34 , 35 ]. The second recruitment source was two large community health clinics.…”

Section: Methodsmentioning

confidence: 99%

“Like a pickle that’s been unpickled”: Emotional, identity and behavioural transformations throughout hepatitis C treatment

et al. 2022

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Background Little is known about the emotional experience and benefits of undertaking direct acting antiviral (DAA) treatment for hepatitis C. A better understanding of individual treatment outcomes can inform acceptable treatment delivery and promotion. We aimed to explore participant-perceived emotional benefits and transformations throughout DAA treatment among people who inject drugs, who were initiating treatment. Methods Participants were recruited from either a community based clinical trial or community health clinics. Semi structured interviews were conducted with each participant before, during and following treatment. Interviews focussed on treatment perceptions, physical and mental wellbeing and modifiable health behaviours. Interviews were recorded, transcribed verbatim and thematically analysed. Participant and cohort matrices were produced to assess at which time point themes were present and whether themes changed or remained stable over time. Results This paper presents analysis from 19 participants interviewed between 2017–2019. Most participants were male, with no or mild fibrosis. At baseline, all but one participant had injected drugs in the past month. Three themes relating to the emotional wellbeing and behaviour change described a common treatment experience; ‘hopes for better wellbeing’, ‘lifting the weight’ and ‘closing the chapter’. Participants were hopeful treatment would improve their emotional wellbeing. Hopes were actualised during treatment as participants began to feel uncertainty and stress easing. Completing treatment improved some participants perceptions of self. Some participants consciously changed their injecting behaviours during treatment. Conclusion Undertaking and completing treatment was an emotionally and behaviourally transformative period. Participant perceived benefits should be used to inform how treatment benefit is conceptualised and how treatment is promoted in primary care settings.

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“…April goes on to explain her experience with the treatment and prevention (TAP) study (Goutzamanis et al, 2021) in more detail: I remember it was really easy for me, I mean, I didn't need to go out searching to get on medication or anything. I found out because I was doing a study to get money.…”

Section: Case 1: Aprilmentioning

confidence: 99%

“…April goes on to explain her experience with the treatment and prevention (TAP) study (Goutzamanis et al , 2021) in more detail:…”

Section: Case 1: Aprilmentioning

confidence: 99%

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

McColl,

Higgs,

Harney

2024

DHS

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Purpose Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential to ensure no one is left behind in hepatitis C elimination efforts. This study aims to explore peoples’ experiences of unstable housing and health care, and how these experiences influenced engagement in hepatitis C treatment. Design/methodology/approach Purposive sampling was used to recruit people with lived experience of injection drug use, hepatitis C and unstable housing in Melbourne, Australia. In-depth semistructured interviews were conducted and a case study approach with interpretative phenomenological analysis was used to identify personal experiential themes and group experiential themes. Findings Four people were interviewed. The precarious nature of housing for women who inject drugs was a group experiential theme, however, this did not appear to be a direct barrier to hepatitis C treatment. Rather, competing priorities, including caregiving, were personal experiential themes and these created barriers to treatment. Another group experiential theme was “right place, right time, right people” with these three elements required to facilitate hepatitis C treatment. Originality/value There is limited research providing in-depth insight into how personal experiences with unstable housing and health care shape engagement with hepatitis C treatment. The analyses indicate there is a need to move beyond a “one size fits-all” approach to hepatitis C care. Instead, care should be tailored to the needs of individuals and their personal circumstances and regularly facilitated. This includes giving greater attention to gender in intervention design and evaluation, and research more broadly.

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Patient‐reported outcomes of the Treatment and Prevention Study: A real‐world community‐based trial of direct‐acting antivirals for hepatitis C among people who inject drugs

Cited by 9 publications

References 39 publications

A novel point-of-care test for cirrhosis based on dimeric to monomeric IgA ratio in blood: a pilot cohort study

A novel point-of-care test for cirrhosis based on dimeric to monomeric IgA ratio in blood: a pilot cohort study

“Like a pickle that’s been unpickled”: Emotional, identity and behavioural transformations throughout hepatitis C treatment

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

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