Predictors of treatment outcomes for Hepatitis C infection in a nationwide elimination program in Iceland: The treatment as prevention for Hepatitis C (TraP HepC) study

被引:0
作者
Olafsson, Sigurdur [1 ,2 ]
Love, Thorvardur Jon [2 ,7 ]
Fridriksdottir, Ragnheidur Hulda [1 ]
Tyrfingsson, Thorarinn [3 ]
Runarsdottir, Valgerdur [3 ]
Hansdottir, Ingunn [3 ,4 ]
Bergmann, Ottar Mar [1 ]
Bjornsson, Einar Stefan [1 ,2 ]
Johannsson, Birgir [5 ]
Sigurdardottir, Bryndis [5 ]
Love, Arthur [2 ,6 ]
Baldvinsdottir, Guorun Erna [6 ]
Thordardottir, Marianna [8 ]
Hernandez, Ubaldo Benitez [7 ]
Heimisdottir, Maria [2 ,9 ]
Hellard, Margaret [10 ,11 ]
Gottfredsson, Magnus [2 ,5 ,7 ]
机构
[1] Landspitali Univ Hosp, Dept Gastroenterol & Hepatol, Reykjavik, Iceland
[2] Univ Iceland, Fac Med, Sch Hlth Sci, Reykjavik, Iceland
[3] Univ Iceland, Reykjavik, Iceland
[4] Univ Iceland, Fac Psychol, Sch Hlth Sci, Reykjavik, Iceland
[5] Landspitali Univ Hosp Fossvogur, Dept Infect Dis, Fossvogur, Iceland
[6] Landspitali Univ Hosp, Dept Virol, Reykjavik, Iceland
[7] Landspitali Univ Hosp, Dept Sci, Reykjavik, Iceland
[8] Directorate Hlth, Reykjavik, Iceland
[9] Iceland Hlth Insurance, Reykjavik, Iceland
[10] Burnet Inst, Melbourne, Australia
[11] Alfred Hosp, Dept Infect Dis, Melbourne, Vic, Australia
关键词
Hepatitis C virus elimination; Injection drug use; Direct acting antivirals; Hepatitis C virus infection; INJECT DRUGS; PEOPLE; CARE; HIV; HCV;
D O I
10.1016/j.drugpo.2024.104616
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: Limited data exists about treatment outcomes in nationwide hepatitis C virus (HCV) elimination programs where injection drug use (IDU) is the main mode of transmission. In 2016 Iceland initiated the HCV elimination program known as Treatment as Prevention for Hepatitis C (TraP HepC). Factors associated with HCV cure in this population are examined. Methods: Unrestricted access was offered to direct acting antiviral agents (DAAs). Testing and harm reduction was scaled up and re-treatments were offered for those who did not attain cure. Cure rates for the first 36 months were assessed and factors associated with failure to achieve cure analysed using multivariable logistic regression. Results: Treatment was initiated for 718; 705 consented for the study. Median age was 44 years (IQR 35-56), history of IDU reported by 593 (84.1 %), recent IDU by 234 (33.2 %); 48 (6.8 %) were homeless. Of 705 patients, 635 achieved cure (90.1 %) during the first treatment. A total of 70 (9.9 %) patients initiated two or more treatments, resulting in 673 participants cured (95.5 %). By multivariable analysis, homelessness was the only statistically significant independent factor associated with not achieving cure (OR 2.67, 95 % CI 1.32-5.41) after first treatment attempt. Conclusion: By reengagement in care and prompt retreatment when needed, a cure rate of 95.5 % was achieved. Unstable housing, a potentially actionable factor is associated with poor outcome.
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页数:7
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