Affiliation:
1. St Vincent's Hospital Melbourne Melbourne VIC
2. The University of Melbourne Melbourne VIC
3. North Richmond Community Health Melbourne VIC
4. The Burnet Institute Melbourne VIC
5. Monash University Melbourne VIC
6. Alfred Health Melbourne VIC
7. The Royal Melbourne Hospital Melbourne VIC
Abstract
AbstractObjectiveTo evaluate the feasibility of testing and treating people who inject drugs at a supervised injecting facility for hepatitis C virus (HCV) infection.DesignRetrospective cohort study.Setting, participantsPeople who inject drugs who attended the Melbourne supervised injecting facility, 30 June 2018 – 30 June 2020.Main outcome measuresProportion of people tested for hepatitis C; proportions of people positive for anti‐HCV antibody and HCV RNA, and of eligible people prescribed direct‐acting antiviral (DAA) treatment; sustained virological response twelve weeks or more after treatment completion.ResultsOf 4649 people who attended the supervised injecting facility during 2018–20, 321 were tested for hepatitis C (7%); 279 were anti‐HCV antibody‐positive (87%), of whom 143 (51%) were also HCV RNA‐positive. Sixty‐four of 321 had previously been treated for hepatitis C (20%), 21 had clinically identified cirrhosis (7%), eight had hepatitis B infections (2%), and four had human immunodeficiency virus infections (1%). In multivariate analyses, people tested for hepatitis C were more likely than untested clients to report psychiatric illness (adjusted odds ratio [aOR], 9.65; 95% confidence interval [CI], 7.26–12.8), not have a fixed address (aOR, 1.59; 95% CI, 1.18–2.14), and to report significant alcohol use (aOR, 1.57; 95% CI, 1.06–2.32). The median number of injecting facility visits was larger for those tested for hepatitis C (101; interquartile range [IQR], 31–236) than for those not tested (20; IQR, 3–90). DAA treatment was prescribed for 126 of 143 HCV RNA‐positive clients (88%); 41 of 54 with complete follow‐up data were cured (76%).ConclusionsPeople who attend supervised injecting facilities can be tested and treated for hepatitis C on site. Models that provide streamlined, convenient hepatitis C care promote engagement with treatment in a group in which the prevalence of hepatitis C is high.
Reference22 articles.
1. World Health Organization.Hepatitis C: key facts. 24 June 2022.https://www.who.int/news‐room/fact‐sheets/detail/hepatitis‐c(viewed Oct 2022).
2. The epidemiology of hepatitis C in Australia: Notifications, treatment uptake and liver transplantations, 1997-2006
3. Australian Department of Health.Fifth national hepatitis C strategy: 2018–2022. 2018. https://www.health.gov.au/sites/default/files/documents/2022/06/fifth‐national‐hepatitis‐c‐strategy‐2018‐2022.pdf(viewed Oct 2021).
4. Hepatitis C treatment in a co‐located mental health and alcohol and drug service using a nurse‐led model of care
5. Integrated models of care for people who inject drugs and live with hepatitis C virus: A systematic review
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献