Hepatitis C virus testing, liver disease assessment and treatment uptake among people who inject drugs pre- and post-universal access to direct-acting antiviral treatment in Australia: The LiveRLife study

被引：48

作者：

Bajis, Sahar ^{[1
]}

Grebely, Jason ^{[1
]}

Hajarizadeh, Behzad ^{[1
]}

Applegate, Tanya ^{[1
]}

Marshall, Alison D. ^{[1
,2
]}

Ellen Harrod, Mary ^{[3
]}

Byrne, Jude ^{[4
]}

Bath, Nicky ^{[3
,24
]}

Read, Phillip ^{[5
,25
]}

Edwards, Michael ^{[6
,28
]}

Gorton, Carla ^{[7
]}

Hayllar, Jeremy ^{[8
,30
]}

Cock, Victoria ^{[9
]}

Peterson, Steven ^{[10
]}

Thomson, Claire ^{[11
]}

Weltman, Martin ^{[12
]}

Jefferies, Meryem ^{[13
]}

Wood, William ^{[14
,26
]}

Haber, Paul ^{[15
]}

Ezard, Nadine ^{[16
,17
,29
]}

Martinello, Marianne ^{[1
]}

Maher, Lisa ^{[1
,18
]}

Dore, Gregory J. ^{[1
]}

Grebely, Jason ^{[1
]}

Harrod, Mary Ellen ^{[3
]}

Peolim, Lucy ^{[3
]}

How-Chow, Dianne ^{[19
]}

Telenta, Jo ^{[20
]}

Byrne, Jude ^{[4
]}

Harvey, Paul ^{[21
]}

Jones, Sandra ^{[22
]}

Dunlop, Adrian ^{[23
]}

Treloar, Carla ^{[2
]}

Samuel, Yvonne ^{[3
]}

Poeder, Fiona ^{[3
]}

Bath, Nicky ^{[3
,24
]}

Crawford, Sione ^{[3
]}

Baxter, Alicia ^{[19
]}

Keats, Julian ^{[23
]}

Dore, Gregory J. ^{[1
]}

Grebely, Jason ^{[1
]}

Mowat, Yasmin ^{[1
]}

Silk, David ^{[1
]}

Micallef, Michelle ^{[1
]}

Bajis, Sahar ^{[1
]}

Tamaddoni, Mahshid ^{[1
]}

Marks, Pip ^{[1
]}

Applegate, Tanya ^{[1
]}

Lamoury, Francois ^{[1
]}

机构：

[1] UNSW Sydney, Kirby Inst, Sydney, NSW, Australia

[2] UNSW Sydney, Ctr Social Res Hlth, Sydney, NSW, Australia

[3] NSW Users & AIDS Assoc, Sydney, NSW, Australia

[4] Australian Injecting & Illicit Drug Users Leagu, Canberra, ACT, Australia

[5] Kirketon Rd Ctr, Sydney, NSW, Australia

[6] South Western Sydney Local Hlth Dist Drug Hlth Se, Sydney, NSW, Australia

[7] Cairns Sexual Hlth Serv, Cairns, Qld, Australia

[8] Metro North Hosp & Hlth Serv, Alcohol & Drug Serv, Metro North Mental Hlth, Brisbane, Qld, Australia

[9] Drug & Alcohol Serv South Australia, Adelaide, SA, Australia

[10] Orange Aboriginal Med Serv, Orange, NSW, Australia

[11] Bayside Alcohol & Drug Serv, Cleveland, Qld, Australia

[12] Gateway Clin Nepean Hosp, Sydney, NSW, Australia

[13] Western Sydney Local Hlth Dist, Sydney, NSW, Australia

[14] Sydney Med Supervised Injecting Ctr, Sydney, NSW, Australia

[15] Royal Prince Alfred Hosp, Sydney, NSW, Australia

[16] St Vincents Hosp, Alcohol & Drug Serv, Sydney, NSW, Australia

[17] UNSW Sydney, Fac Med, Sydney, NSW, Australia

[18] Burnet Inst, Melbourne, Vic, Australia

[19] St Vincents Hosp Sydney, Sydney, NSW, Australia

[20] Australian Catholic Univ, Sydney, NSW, Australia

[21] Hepatitis NSW, Surry Hills, NSW, Australia

[22] Univ Wollongong, Wollongong, NSW, Australia

[23] Newcastle Pharmacotherapy Serv, Newcastle West, NSW, Australia

[24] ACON, Surry Hills, NSW, Australia

[25] Kirketon Rd Ctr, Darlinghurst, NSW, Australia

[26] Uniting Sydney Medically Supervised Injecting Ctr, Potts Point, NSW, Australia

[27] Coffs Harbour Drug & Alcohol Serv, Potts Point, NSW, Australia

[28] Campbelltown Drug Hlth Serv, Campbelltown, NSW, Australia

[29] Rankin Court, Darlinghurst, NSW, Australia

[30] Metro North Hosp & Hlth Serv, Brisbane, Qld, Australia

[31] Blacktown Opioid Treatment Clin, Blacktown, NSW, Australia

来源：

JOURNAL OF VIRAL HEPATITIS | 2020年 / 27卷 / 03期

基金：

澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;

关键词：

cascade of care; direct-acting antiviral; hepatitis C virus; linkage to care; treatment uptake; NATURAL-HISTORY; FIBROSIS PROGRESSION; AUDIT-C; INFECTION; USERS; CARE; BARRIERS; METAANALYSIS; INDIVIDUALS;

D O I：

10.1111/jvh.13233

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treatment uptake among people who inject drugs (PWID) persist. We aimed to describe the cascade of HCV care among PWID in Australia, prior to and following unrestricted access to direct-acting antiviral (DAA) treatment. Participants enrolled in an observational cohort study between 2014 and 2018 provided fingerstick whole-blood samples for dried blood spot, Xpert HCV Viral Load and venepuncture samples. Participants underwent transient elastography and clinical assessment by a nurse or general practitioner. Among 839 participants (mean age 43 years), 66% were male (n = 550), 64% (n = 537) injected drugs in the previous month, and 67% (n = 560) reported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had detectable HCV RNA, of whom 23% (n = 86) received HCV treatment within 12 months of enrolment. HCV treatment uptake increased from 2% in the pre-DAA era to 38% in the DAA era. Significant liver fibrosis (F2-F4) was more common in participants with HCV infection (38%) than those without (19%). Age 50 years or older (aOR, 2.88; 95% CI, 1.18-7.04) and attending a clinical follow-up with nurse (aOR, 3.19; 95% CI, 1.61-6.32) or physician (aOR, 11.83; 95% CI, 4.89-28.59) were associated with HCV treatment uptake. Recent injection drug use and unstable housing were not associated with HCV treatment uptake. HCV treatment uptake among PWID has increased markedly in the DAA era. Evaluation of innovative and simplified models of care is required to further enhance treatment uptake.

引用

页码：281 / 293

页数：13

共 49 条

[11] Prospective comparison of transient elastography, fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C [J].