Potential interventions to support HCV treatment uptake among HIV co-infected people in Canada: Perceptions of patients and health care providers

Abstract

BACKGROUND: Increasing direct-acting antiviral (DAA) treatment uptake is key to eliminating HCV infection as a public health threat in Canada. People living with human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection face barriers to HCV treatment initiation. We sought to identify interventions that could support HCV treatment initiation based on patient and HCV care provider perspectives. METHODS: Eleven people living with HIV with a history of HCV infection and 12 HCV care providers were recruited for this qualitative descriptive study. Participants created ranked-ordered lists of potential interventions during nominal groups ( n = 4) and individual interviews ( n = 6). Following the nominal group technique, transcripts and intervention lists underwent thematic analysis and ranking scores were merged to create consolidated and prioritized lists from patient and provider perspectives. RESULTS: Patient participants identified a total of eight interventions. The highest-ranked interventions were multidisciplinary clinics, HCV awareness campaigns and patient education, nurse- or pharmacist-led care, peer involvement, and more and better-prepared health professionals. Provider participants identified 11 interventions. The highest-ranked were mobile outreach, DAA initiation at pharmacies, a simplified process of DAA prescription, integration of primary and specialist care, and patient-centred approaches. CONCLUSION: Participants proposed alternatives to hospital-based specialist HCV care, which require increasing capacity for nurses, pharmacists, primary care providers, and peers to have more direct roles in HCV treatment provision. They also identified the need for structural changes and educational initiatives. In addition to optimizing HCV care, these interventions might result in broader benefits for the health of HIV–HCV co-infected people.

Hcv Reinfection in Active Drug Users from Facts to Explanations and Possible Solutions

“…All the actions implemented by our team, which is in addition to the actions usually carried out, allowed a significant decrease in the HCV re-infection rate, decreased to 22% (figure 2). They confirm the results of previous studies [27][28][29][30].…”

Trends in hepatitis C virus coinfection and its cascade of care among adults living with HIV in Asia between 2010 and 2020

“…These, and the other persistent gaps in the chronic HCV cascade of care we identified are particularly concerning given the burden of HCV/HIV co-infection in the Asia-Pacific region and emphasize the need for focused efforts to strengthen chronic HCV screening, pre-treatment testing, HCV treatment initiation, and monitoring. In support of these efforts, novel interventions should be considered or scaled up in the region, including point-of-care antibody testing [51], reducing diagnostic and DAA costs [52], non-specialist-led HCV care and treatment [53,54] and community-led same day test and treat models [55]. Improved HCV screening and scale-up of HCV treatment are also important for reducing the risk of HCV re-infection amongst PLHIV [56].…”