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Griffin S, Lee Wilkinson A, Winter R, Hajarizadeh B, MacIsaac M, Papaluca T, Holmes J, Lloyd AR, Carson J, Craigie A, Hellard M, Stoové M, Thompson A. Contribution of prison-based hepatitis C treatment initiations to overall treatment uptake in Victoria, Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 48:101139. [PMID: 39045483 PMCID: PMC11265497 DOI: 10.1016/j.lanwpc.2024.101139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/03/2024] [Accepted: 06/25/2024] [Indexed: 07/25/2024]
Affiliation(s)
- Samara Griffin
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Anna Lee Wilkinson
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Winter
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
| | | | - Michael MacIsaac
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Timothy Papaluca
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Jacinta Holmes
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Andrew R. Lloyd
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Joanne Carson
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Anne Craigie
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Margaret Hellard
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Australia
| | - Mark Stoové
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Alexander Thompson
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
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Read P, Tang BZH, Silins E, Doab A, Cornelisse VJ, Gilliver R. Hepatitis C (HCV) Reinfection and Risk Factors among Clients of a Low-Threshold Primary Healthcare Service for People Who Inject Drugs in Sydney, Australia. Viruses 2024; 16:957. [PMID: 38932249 PMCID: PMC11209512 DOI: 10.3390/v16060957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Hepatitis C (HCV) reinfection studies have not focused on primary healthcare services in Australia, where priority populations including people who inject drugs (PWID) typically engage in healthcare. We aimed to describe the incidence of HCV reinfection and associated risk factors in a cohort of people most at risk of reinfection in a real-world community setting. We conducted a secondary analysis of routinely collected HCV testing and treatment data from treatment episodes initiated with direct-acting antiviral (DAA) therapy between October 2015 and June 2021. The overall proportion of clients (N = 413) reinfected was 9% (N = 37), and the overall incidence rate of HCV reinfection was 9.5/100PY (95% CI: 6.3-14.3). Reinfection incidence rates varied by sub-group and were highest for Aboriginal and/or Torres Strait Islander people (20.4/100PY; 95% CI: 12.1-34.4). Among PWID (N= 321), only Aboriginality was significantly associated with reinfection (AOR: 2.73, 95% CI: 1.33-5.60, p = 0.006). High rates of HCV reinfection in populations with multiple vulnerabilities and continued drug use, especially among Aboriginal and Torres Strait Islander people, highlight the need for ongoing regular HCV testing and retreatment in order to achieve HCV elimination. A priority is resourcing testing and treatment for Aboriginal and/or Torres Strait Islander people. Our findings support the need for novel and holistic healthcare strategies for PWID and the upscaling of Indigenous cultural approaches and interventions.
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Affiliation(s)
- Phillip Read
- Kirketon Road Centre, Kings Cross, P.O. Box 22, Sydney, NSW 1340, Australia; (E.S.); (A.D.); (R.G.)
- Kirby Institute, UNSW Australia, Sydney, NSW 2032, Australia
| | | | - Edmund Silins
- Kirketon Road Centre, Kings Cross, P.O. Box 22, Sydney, NSW 1340, Australia; (E.S.); (A.D.); (R.G.)
- National Drug and Alcohol Research Centre (NDARC), UNSW Australia, Sydney, NSW 2052, Australia
| | - Anna Doab
- Kirketon Road Centre, Kings Cross, P.O. Box 22, Sydney, NSW 1340, Australia; (E.S.); (A.D.); (R.G.)
| | - Vincent J. Cornelisse
- Kirketon Road Centre, Kings Cross, P.O. Box 22, Sydney, NSW 1340, Australia; (E.S.); (A.D.); (R.G.)
- Kirby Institute, UNSW Australia, Sydney, NSW 2032, Australia
| | - Rosie Gilliver
- Kirketon Road Centre, Kings Cross, P.O. Box 22, Sydney, NSW 1340, Australia; (E.S.); (A.D.); (R.G.)
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Rance J, Grebely J, Treloar C. The time of cure: hepatitis C treatment and the matter of reinfection among people who inject drugs. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024; 33:104-118. [PMID: 38373415 DOI: 10.1080/14461242.2024.2315031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024]
Abstract
Australia has made considerable progress towards the public-health 'elimination' of the hepatitis C virus. Nonetheless, reinfection remains a key challenge, with little understanding regarding the lived complexities of post-cure life among people who inject drugs. Our analysis examines reinfection through the lens of 'time', a largely overlooked and under-utilised analytical concept within the field of hepatitis C. Drawing on qualitative data from a study examining treatment outcomes and reinfection, our analysis concentrates on three participant accounts or 'cases'. Working within a new materialist framework, we combine recent social science scholarship which, firstly, posits cure as a socio-material 'gathering', and secondly, proposes a 'futurology' of hepatitis C and its treatment. We found participant accounts troubled the neat binary of pre- and post-treatment life, instead detailing the challenges of remaining virologically safe while navigating complex, local life-worlds. Rather than a singular, post-treatment future instantiated by cure, participants described the fluid, emergent nature of what we might describe as 'lived' or 'embodied' time, including multiplicities of becoming in a perpetual present. We conclude that our understanding of reinfection needs to move beyond its current, narrow biomedical conception and organising temporal logic to honour and incorporate complexity in practice.
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Affiliation(s)
- J Rance
- Centre for Social Research in Health, UNSW, Sydney, Australia
| | - J Grebely
- The Kirby Institute, UNSW, Sydney, Australia
| | - C Treloar
- Centre for Social Research in Health, UNSW, Sydney, Australia
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