Toward Elimination of Hepatitis C Infection: How Best to Address Gaps in the Cascade of Care?

Prabhakar, V; Kwo, Paul Y.

doi:10.1002/hep4.1403

Cited by 5 publications

(3 citation statements)

References 8 publications

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“… 23 Despite these universal recommendations for HCV screening in routine antenatal clinics as part of antenatal checkups, the uptake of these recommendations in clinical practice is impaired, particularly in developing countries where health systems are weak and shortages of healthcare facilities as well as the health workforce are common. 24 This shows that in these nations, immediate effort is required to raise education of Hepatitis-C and its detection and intervention treatment.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis-C during Pregnancy: Antenatal period challenges, management and the way forward

Kamani,

Abdul Razzak

2023

Pak J Med Sci

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Pregnant women and the general public are both directly impacted by cirrhosis which is a chronic liver disease. It is also widely known that women who have a history of injectable drug use and cirrhosis are more prone to experience unfavorable consequences that have a negative impact on the health of both the mother and the unborn child. Higher maternal Hepatitis-C Virus (HCV) in pregnancy viral load, length of labor, use of amniocentesis or fetal scalp monitoring and protracted membrane rupture are all the risk of perinatal transmission of HCV in newborns. Globally, a large number of childbearing-age women become affected by HCV every year and vertical transmission of HCV is still a serious public health concern. Pregnancy-related immune alterations have a significant impact on the course of HCV infection throughout the third trimester and provide favorable circumstances for the spread of the virus. The exacerbation of hepatic damage during pregnancy and the postpartum period is mostly responsible for HCV-specific cell-mediated immune responses. An extensive literature search done via electronic search engine including Cochrane library databases, PubMed, Google Scholar, Science Direct and HCV in pregnancy articles were included. doi: https://doi.org/10.12669/pjms.40.1.7578 How to cite this: Kamani L, Razzak AA. Hepatitis-C during Pregnancy: Antenatal period challenges, management and the way forward. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.7578 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Hepatitis-C during Pregnancy: Antenatal period challenges, management and the way forward

Kamani,

Abdul Razzak

2023

Pak J Med Sci

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“…First developed in response to the HIV/AIDS epidemic (Gardner et al, 2011), a cascade of care tracks the proportion of the population of interest engaged in each step of a care continuum including diagnosis, engagement in medical care, receipt of treatment, retention in care, and remission of disease (U.S. Department of Health & Human Services, 2020). A cascade of care framework has been adopted for other chronic diseases (Kazemian et al, 2019; Prabhakar & Kwo, 2019; Thomas, 2020), including opioid use disorder (Williams et al, 2019), to illustrate where gaps in care occur so that interventions can be targeted with the ultimate goal of decreasing mortality and improving disease outcomes. Constructing a cascade of care for AUD can therefore serve as a helpful tool to visualize gaps in the care continuum so that interventions to mitigate identified gaps can be appropriately targeted.…”

Section: Introductionmentioning

confidence: 99%

A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care

Mintz

Hartz

Fisher

et al. 2021

Alcoholism Clin & Exp Res

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Background Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care for persons with AUD. Methods Using 2015–2019 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: (1) adult prevalence of AUD; (2) proportion of adults with AUD who utilized health care in the past 12 months; (3) proportion with AUD screened about their alcohol use; (4) proportion with AUD who received a brief intervention about their alcohol misuse; (5) proportion with AUD who received information about treatment for alcohol misuse; and (6) proportion with AUD who received treatment. Analyses were stratified by AUD severity. Results Of the 214,505 persons included in the sample, the weighted prevalence of AUD was 7.8% (95% CI 7.6–8.0%). Cascades of care showed the majority of individuals with AUD utilized health care in the past 12 months [81.4% (95% CI 80.7–82.1%)] and were screened about alcohol use [69.9% (95% CI 68.9–70.8%)]. However, only a minority of individuals received subsequent steps of care, including 11.6% (95% CI 11.0–12.2%) who reported receiving a brief intervention, 5.1% (95% CI 4.6–5.6%) who were referred to treatment, and 5.8% (95% CI 5.4–6.3%) who received treatment. Similar patterns were observed when cascades of care were stratified by AUD severity. Conclusions Persons with AUD commonly utilize health care and are often screened about alcohol use, but few receive treatment. Healthcare settings—particularly primary care settings—represent a prime opportunity to implement AUD treatment to improve outcomes in this high‐risk population.

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“…Department of Health & Human Services, 2020). A cascade of care framework has been adopted for other chronic diseases (Kazemian et al, 2019; Prabhakar and Kwo, 2019; Thomas, 2020), including opioid use disorder (Williams et al, 2019), to illustrate where gaps in care occur so that interventions can be targeted with the ultimate goal of decreasing mortality and improving disease outcomes.…”

Section: Introductionmentioning

confidence: 99%

A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

et al. 2020

Preprint

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Background: Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD. Methods: Using 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity. Results: Of the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system. Conclusions: Persons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings- particularly primary care settings- represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.

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Toward Elimination of Hepatitis C Infection: How Best to Address Gaps in the Cascade of Care?

Cited by 5 publications

References 8 publications

Hepatitis-C during Pregnancy: Antenatal period challenges, management and the way forward

Hepatitis-C during Pregnancy: Antenatal period challenges, management and the way forward

A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care

A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

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