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Mathur P, Ramadhani HO, Kaplan R, Stafford KA, Theppote A, Wilson E. Interferon-free hepatitis C treatment increases a surrogate of atherosclerotic cardiovascular disease risk in Black veterans living with HIV. AIDS 2024; 38:1437-1439. [PMID: 38932748 DOI: 10.1097/qad.0000000000003900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Veterans living with HIV (VLWH) and hepatitis C virus (HCV) co-infection have an exacerbated risk of cardiovascular disease (CVD). It is unknown if HCV cure reduces CVD risk in this population. We evaluated changes in low-density lipoprotein (LDL), as a surrogate of CVD risk, 18 months after HCV cure in VLWH. We found significant increases in LDL in VLWH with advanced fibrosis, potentially increasing CVD risk. Lower LDL thresholds to initiate lipid-lowering therapies in VLWH after HCV cure may be warranted.
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Affiliation(s)
- Poonam Mathur
- Institute of Human Virology, University of Maryland School of Medicine
| | - Habib O Ramadhani
- Institute of Human Virology, University of Maryland School of Medicine
| | - Roman Kaplan
- Baltimore VA Medical Healthcare Center, Baltimore, MD
| | | | | | - Eleanor Wilson
- Institute of Human Virology, University of Maryland School of Medicine
- Baltimore VA Medical Healthcare Center, Baltimore, MD
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2
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Passos-Castilho AM, Udhesister STP, Fontaine G, Jeong D, Dickie M, Lund C, Russell R, Kronfli N. The 11th Canadian Symposium on Hepatitis C Virus: 'Getting back on track towards hepatitis C elimination'. CANADIAN LIVER JOURNAL 2023; 6:56-69. [PMID: 36908576 PMCID: PMC9997521 DOI: 10.3138/canlivj-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/20/2022] [Indexed: 11/05/2022]
Abstract
Hepatitis C virus (HCV) affects approximately 204,000 Canadians. Safe and effective direct-acting antiviral therapies have contributed to decreased rates of chronic HCV infection and increased treatment uptake in Canada, but major challenges for HCV elimination remain. The 11th Canadian Symposium on Hepatitis C Virus took place in Ottawa, Ontario on May 13, 2022 as a hybrid conference themed 'Getting back on track towards hepatitis C elimination.' It brought together research scientists, clinicians, community health workers, patient advocates, community members, and public health officials to discuss priorities for HCV elimination in the wake of the COVID-19 pandemic, which had devastating effects on HCV care in Canada, particularly on priority populations. Plenary sessions showcased topical research from prominent international and national researchers, complemented by select abstract presentations. This event was hosted by the Canadian Network on Hepatitis C (CanHepC), with support from the Public Health Agency of Canada and the Canadian Institutes of Health Research and in partnership with the Canadian Liver Meeting. CanHepC has an established record in HCV research and in advocacy activities to address improved diagnosis and treatment, and immediate and long-term needs of those affected by HCV infection. The Symposium addressed the remaining challenges and barriers to HCV elimination in priority populations and principles for meaningful engagement of Indigenous communities and individuals with living and lived experience in HCV research. It emphasized the need for disaggregated data and simplified pathways for creating and monitoring interventions for equitably achieving elimination targets.
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Affiliation(s)
- Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sasha Tejna Persaud Udhesister
- Faculté de Médecine, Université de Montréal, Centre de Recherche du Centre hospitalier de l'Université de Montré (CRCHUM), Montréal, Québec, Canada
| | - Guillaume Fontaine
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dahn Jeong
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melisa Dickie
- Community Health Programming, CATIE, Toronto, Ontario, Canada
| | | | - Rodney Russell
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Nadine Kronfli
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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Robinson E, Byrne CJ, Carberry J, Radley A, Beer LJ, Inglis SK, Tait J, Macpherson I, Goldberg D, Hutchinson SJ, Hickman M, Dillon JF. Laying the foundations for hepatitis C elimination: evaluating the development and contribution of community care pathways to diagnostic efforts. BMC Public Health 2023; 23:54. [PMID: 36611156 PMCID: PMC9826577 DOI: 10.1186/s12889-022-14911-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hepatitis C Virus (HCV) is a public health threat which contributes substantially to the global burden of liver disease. There is much debate about effective approaches to scaling up diagnosis of HCV among risk groups. Tayside, a region in the East of Scotland, developed low-threshold community pathways for HCV to lay the foundations of an elimination strategy. In this retrospective study, we sought to: quantify the contribution of community pathways to increasing HCV diagnosis; understand if shifting diagnosis to community settings led to a higher proportion of individuals tested for HCV being actively infected; and describe functional characteristics of the care pathways. METHODS Descriptive statistics were used to for analysis of routinely-collected HCV testing data from 1999 to 2017, and a review of the development of the care pathways was undertaken. Community-based testing was offered through general practices (GP); nurse outreach clinics; prisons; drug treatment services; needle and syringe provision (NSP) sites; community pharmacies; and mosques. RESULTS Anti-HCV screening was undertaken on 109,430 samples, of which 5176 (4.7%) were reactive. Of all samples, 77,885 (71.2%) were taken in secondary care; 25,044 (22.9%) in GPs; 2970 (2.7%) in prisons; 2415 (2.2%) in drug services; 753 (0.7%) in NSPs; 193 (0.2%) pharmacies; and 170 (0.1%) in mosques. The highest prevalence of HCV infection among those tested was in NSP sites (26%), prisons (14%), and drug treatment centres (12%). CONCLUSIONS Decentralised care pathways, particularly in harm reduction and other drug service settings, were key to increasing diagnosis of HCV in the region, but primary and secondary care remain central to elimination efforts.
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Affiliation(s)
- Emma Robinson
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK.,Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Christopher J Byrne
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK. .,Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, UK. .,Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
| | - James Carberry
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK.,Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Andrew Radley
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.,Directorate of Public Health, Kings Cross Hospital, NHS Tayside, Dundee, UK
| | - Lewis J Beer
- Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Sarah K Inglis
- Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Jan Tait
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
| | - Iain Macpherson
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - David Goldberg
- Public Health Scotland, Meridian Court, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sharon J Hutchinson
- Public Health Scotland, Meridian Court, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - John F Dillon
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK.,Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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4
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Beer L, Inglis S, Malaguti A, Byrne C, Sharkey C, Robinson E, Gillings K, Radley A, Hapca A, Stephens B, Dillon J. Randomized clinical trial: Direct-acting antivirals as treatment for hepatitis C in people who inject drugs: Delivered in needle and syringe programs via directly observed therapy versus fortnightly collection. J Viral Hepat 2022; 29:646-653. [PMID: 35582875 PMCID: PMC9544056 DOI: 10.1111/jvh.13701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/18/2022] [Accepted: 04/03/2022] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) treatment in people who inject drugs (PWID) is delivered within settings frequented by PWID, such as needle and syringe programs (NSP). The optimal direct-acting antiviral (DAA) dispensing regimen among NSP clients is unknown. This study compared cures (Sustained virologic response 12 weeks post-treatment, [SVR12 ]) across three dispensing schedules to establish non-inferiority of fortnightly dispensing versus directly observed therapy. The ADVANCE HCV study was a randomized, unblinded trial, recruiting PWID attending NSP in Tayside, Scotland, between January 2018 and November 2019. HCV-positive participants were randomized to receive DAAs via directly observed therapy, fortnightly provision or fortnightly provision with psychological intervention. A modified intention to treat analysis was used to identify differences in cures between the three treatment regimes. The study was registered with clinicaltrials.gov; NCT03236506. A total of 110 participants completed the study. 33 participants received directly observed therapy, with 90.91% SVR12 ; 37 received fortnightly provision, with 86.49% SVR12 and 40 received fortnightly provision and psychological intervention at treatment initiation, with 92.50% SVR12 . Analysis showed no significant difference in SVR12 (p = 0.67). This study did not demonstrate a statistically significant difference in cure rate between groups. This provides evidence of the non-inferiority of fortnightly dispensing of direct-acting antivirals (DAAs) compared to directly observed therapy among PWID. It suggests that tight control of adherence through directly observed therapy dispensing of DAAs among this population offers no therapeutic advantage. Therefore, less restrictive dispensing patterns can be used, tailored to patient convenience.
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Affiliation(s)
- Lewis Beer
- Tayside Clinical Trials UnitUniversity of DundeeDundeeUK
| | - Sarah Inglis
- Tayside Clinical Trials UnitUniversity of DundeeDundeeUK
| | - Amy Malaguti
- Tayside Drug & Alcohol Recovery Psychology ServiceNHS TaysideDundeeUK
| | - Christopher Byrne
- Tayside Clinical Trials UnitUniversity of DundeeDundeeUK,Department of Molecular and Clinical MedicineUniversity of DundeeDundeeUK
| | | | - Emma Robinson
- Department of Molecular and Clinical MedicineUniversity of DundeeDundeeUK,Ninewells Hospital and Medical SchoolNHS TaysideDundeeScotland
| | | | | | - Adrian Hapca
- Tayside Clinical Trials UnitUniversity of DundeeDundeeUK
| | - Brian Stephens
- Ninewells Hospital and Medical SchoolNHS TaysideDundeeScotland
| | - John Dillon
- Department of Molecular and Clinical MedicineUniversity of DundeeDundeeUK,Ninewells Hospital and Medical SchoolNHS TaysideDundeeScotland
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5
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Byrne CJ, Beer L, Inglis SK, Robinson E, Radley A, Goldberg DJ, Hickman M, Hutchinson S, Dillon JF. Real-world outcomes of rapid regional hepatitis C virus treatment scale-up among people who inject drugs in Tayside, Scotland. Aliment Pharmacol Ther 2022; 55:568-579. [PMID: 34877667 PMCID: PMC9300005 DOI: 10.1111/apt.16728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/03/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND In 2017, Tayside, a region in the East of Scotland, rapidly scaled-up Hepatitis C Virus (HCV) outreach and treatment among People Who Inject Drugs (PWID) using novel community care pathways. AIMS We aimed to determine treatment outcomes for PWID during the scale-up against pre-determined targets; and assess re-infection, mortality, and post-treatment follow up. METHODS HCV treatment was delivered in community pharmacies, drug treatment centres, nurse-led outreach clinics, prisons, and needle exchanges, alongside conventional hospital care. We retrospectively analysed clinical outcomes and compared pathways using logistic regression models. RESULTS Of 800 estimated HCV-infected PWID, 718 (90%) were diagnosed. 713 treatments commenced among 662 (92%) PWID, delivering 577 (81%) Sustained Virologic Responses (SVR). SVR was 91% among those who attended for testing. Forty-six individuals were treated more than once. Needle exchanges and community pharmacies initiated 49% of all treatments. Regression analyses implied pharmacies had superior follow-up, but there was no difference in likelihood of achieving SVR in community pathways relative to hospital care. Re-infection occurred 39 times over 256.57 person years (PY), yielding a rate of 15.20 per 100 PY (95% CI 10.81-20.78). 54 deaths occurred (29 drug related) over 1,553.04 PY, yielding a mortality rate of 3.48 per 100 PY (95% CI 2.61-4.54). Drug-related mortality was 1.87 per 100 PY (95% CI 1.25-2.68). CONCLUSIONS Rapid HCV treatment scale-up to PWID in community settings, whilst maintaining high SVR, is achievable. However, other interventions are required to minimise re-infection; reduce drug-related deaths; and improve post-SVR follow-up testing regionally.
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Affiliation(s)
- Christopher J Byrne
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, UK.,Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Lewis Beer
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Sarah K Inglis
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Emma Robinson
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, UK.,Department of Gastroenterology, Ninewells Hospital & Medical School, Dundee, UK
| | - Andrew Radley
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, UK.,Directorate of Public Health, National Health Service Tayside, Dundee, UK
| | - David J Goldberg
- Public Health Scotland, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sharon Hutchinson
- Public Health Scotland, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - John F Dillon
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, UK.,Department of Gastroenterology, Ninewells Hospital & Medical School, Dundee, UK
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Khalsa JH, Mathur P. Hepatitis C Virus Infection in Persons Who Inject Drugs in the Middle East and North Africa: Intervention Strategies. Viruses 2021; 13:1363. [PMID: 34372569 PMCID: PMC8310161 DOI: 10.3390/v13071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/04/2021] [Accepted: 07/11/2021] [Indexed: 12/12/2022] Open
Abstract
There is a high incidence and prevalence of hepatitis C viral infection in persons with or without substance use disorders (SUDs) in the Middle East and North Africa (MENA) region, but only a small number receive comprehensive care. Highly effective direct-acting antiviral (DAA) medications are available at substantially lower costs; however, complete elimination of the hepatitis C virus (HCV) can only be achieved if integrated care strategies target those at highest risk for HCV infection and transmission and improve access to care. Due to the high prevalence of SUD in the MENA region, strategies to eliminate HCV must focus on integrated healthcare across multiple subspecialties, including addiction medicine, psychiatry, infectious diseases, hepatology, and social work. In this invited manuscript, we review the epidemiology of HCV in the MENA region and highlight intervention strategies to attain the WHO's goal of HCV eradication by 2030.
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Affiliation(s)
- Jag H. Khalsa
- Medical Consequences of Drug Abuse and Infections Branch, Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Poonam Mathur
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
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7
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Baiano CX, Caven M, Robinson EM, Dillon JF. Evaluating and communicating hepatitis C cascades of care data in Tayside, Scotland: A journey towards elimination. J Viral Hepat 2021; 28:909-915. [PMID: 33759258 DOI: 10.1111/jvh.13505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/15/2021] [Accepted: 03/08/2021] [Indexed: 12/09/2022]
Abstract
Chronic hepatitis C virus (HCV) is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. The WHO 2030 Elimination Goals require each country to evaluate their response to their epidemics. This can be achieved by visualization of cascades of care, depicting how infected cases move through disease control stages. However, methods of displaying data are debated and lack practical application. This project proposes a new way of codifying and displaying HCV data using Tayside as a case study. 1464 cases of active HCV infections in Tayside from 2015 to 2019 were analysed from NHS Tayside's HCV Database. Variables were evaluated to create a systematic coding framework that was then used to code each patient's diagnosis, treatment and cure status each year from 2015 to 2019. Graphical representation of the data in the form of a stacked clustered bar chart demonstrates general trends and conversion rates. For example, Tayside has seen an increase in diagnosis-to-cure rates from 18% to 49% (2015-2019). This method also demonstrates the portion of newly and previously diagnosed people accessing treatment, those with unsuccessful or incomplete treatments, completed treatments with unconfirmed cure, and the number of deaths and relocations. In conclusion, this project proposes a novel way of displaying cascades of care data that relays yearly snapshots of an epidemic, cumulative progression over time, nuanced information of each stage and progression towards elimination targets. This method can be meaningfully used to improve local service planning, knowledge exchange across health systems and reporting to bodies like the WHO.
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Affiliation(s)
- Cassandra X Baiano
- Ninewells Hospital, University of Dundee Medical School, Dundee, Scotland
| | - Madeleine Caven
- Gut Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, Scotland
| | - Emma M Robinson
- Gut Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, Scotland.,Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, Scotland
| | - John F Dillon
- Gut Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, Scotland.,Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, Scotland
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Donaldson SR, Radley A, Dillon JF. Identifying the Hidden Population: Former Intravenous Drug Users Who Are No Longer in Contact with Services. "Ask a Friend". Diagnostics (Basel) 2021; 11:diagnostics11020170. [PMID: 33504077 PMCID: PMC7911884 DOI: 10.3390/diagnostics11020170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 01/08/2023] Open
Abstract
People who, after a period of drug use, have changed their lifestyle and left substance use behind them are a hidden population within our communities. Lack of contact with drug services may mean that they are not tested for hepatitis C (HCV) infection through service-led initiatives and, therefore, may be exposed to the chronic morbidity and risk of death inherent with a legacy of HCV infection. This study utilized respondent-driven sampling (RDS) in a novel fashion to find those at historical risk of HCV. The social networks of people with a history of drug use were mapped, and individuals not currently in contact with services were invited to come forward for testing by members of their social network. The study used a reference group to inform study methodology and communication methods to reach out to this hidden population. One hundred and nine individuals received dry blood spot tests for HCV, 17.4% were antibody positive. Fifty one individuals met the inclusion criteria for this study. One hundred and twenty three invite-to-test coupons were issued; however, only one wave of recruitment consisting of one participant resulted from this method. Using RDS in historical social networks was not effective in this study and did not reach this hidden population and increase testing for HCV. This study is registered with clinicaltrials.gov (Ref NCT03697135).
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Affiliation(s)
- Sarah R. Donaldson
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK; (A.R.); (J.F.D.)
- Directorate of Public Health, NHS Tayside, Dundee DD3 8EA, UK
- Correspondence:
| | - Andrew Radley
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK; (A.R.); (J.F.D.)
- Directorate of Public Health, NHS Tayside, Dundee DD3 8EA, UK
| | - John F. Dillon
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK; (A.R.); (J.F.D.)
- Department of Gastroenterology, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
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Patient Centeredness in Hepatitis C Direct-Acting Antiviral Treatment Delivery to People Who Inject Drugs: A Scoping Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:471-484. [PMID: 33372245 PMCID: PMC8357769 DOI: 10.1007/s40271-020-00489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 11/06/2022]
Abstract
Background and Objective Patient-centered care (PCC) is crucial for value-based care. We aimed to assess PCC dimensions addressed in hepatitis C virus direct-acting antiviral treatment delivery to people who inject drugs. Methods We conducted a scoping review to identify the studies that described hepatitis C virus treatment delivery to people who inject drugs in the direct-acting antiviral treatment era. We analyzed the included studies against eight PCC dimensions: (1) access to care; (2) coordination and integration of care; (3) continuity and translation; (4) physical comfort; (5) information, education, and communication; (6) emotional support; (7) involvement of family and friends; and (8) respect for individual patient preferences, perceived needs, and values. Additionally, we assessed the use of patient-centered terminology and the recognition of PCC importance and its relevance to treatment outcomes. Results None of the identified 36 studies addressed all PCC dimensions (highest seven, lowest two). Our findings revealed that PCC dimensions are prioritized differently and addressed using different approaches and strategies. Studies that used PCC terminology referred to personalized activities, which does not imply comprehensive PCC. About one-third of the studies acknowledged the importance of patient centeredness and two-thirds recognized its relevance to treatment outcomes. Conclusions Our findings suggest more engagement of people who inject drugs and comprehensive involvement of their families and friends in hepatitis C virus treatment journey, decisions, and outcomes. The recognition of PCC importance and its relevance to treatment outcomes in the analyzed studies emphasizes the need for more patient-centered hepatitis C virus treatment for people who inject drugs. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-020-00489-6.
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