A survey of Australian general practitioners’ hepatitis C knowledge and management 2 years after subsidised direct-acting antiviral therapy became available

Sexual Health ◽  
2020 ◽  
Vol 17 (4) ◽  
pp. 387
Author(s):  
Michelle Gooey ◽  
Evelyn Wong ◽  
Alisa Pedrana ◽  
Nicole Allard ◽  
Joseph Doyle ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
General Practitioners ◽  
People Who Inject Drugs ◽  
Knowledge Score ◽  
Direct Acting Antivirals ◽  
Direct Acting Antiviral ◽  
Additional Support ◽  
Direct Acting

In 2016, hepatitis C direct-acting antivirals (DAAs) became available in Australia. A group of general practitioners (GPs) were surveyed twice to assess hepatitis C knowledge and management; 191/1000 (19.1%) responded at baseline, 164/938 (17.5%) at follow up. Participants’ mean Knowledge score increased: baseline 5.75 (95% CI 5.61–5.91), follow up 6.09 (95% CI 5.95–6.22; P <0.01). At follow up, 36/163 (22%) had prescribed DAAs compared with 23/187 (12%) at baseline (χ2(1) = 5.95, P = 0.02); however, 67/150 (45%) were unsure of treatment eligibility for people who inject drugs. Additional support for GPs is warranted to ensure optimal hepatitis C management in primary care.

scholarly journals Low Hepatitis C Reinfection Following Direct-acting Antiviral Therapy Among People Who Inject Drugs on Opioid Agonist Therapy

2019 ◽  
Vol 70 (12) ◽  
pp. 2695-2702 ◽  
Author(s):  
Matthew J Akiyama ◽  
Daniel Lipsey ◽  
Moonseong Heo ◽  
Linda Agyemang ◽  
Brianna L Norton ◽  
...  
Keyword(s):  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Controlled Trial ◽  
Extension Study ◽  
Agonist Therapy ◽  
Opioid Agonist ◽  
Direct Acting Antiviral ◽  
Opioid Agonist Therapy ◽  
Direct Acting

Abstract Background Direct-acting antiviral (DAA) therapy is highly effective in people who inject drugs (PWID); however, rates, specific injection behaviors, and social determinants associated with hepatitis C virus (HCV) reinfection following DAA therapy among PWID on opioid agonist therapy (OAT) are poorly understood. Methods PREVAIL was a randomized controlled trial that assessed models of HCV care for 150 PWID on OAT. Those who achieved sustained virologic response (SVR) (n = 141; 94%) were eligible for this extension study. Interviews and assessments of recurrent HCV viremia occurred at 6-month intervals for up to 24 months following PREVAIL. We used survival analysis to analyze variables associated with time to reinfection. Results Of 141 who achieved SVR, 114 had a least 1 visit in the extension study (62% male; mean age, 52 years). Injection drug use (IDU) was reported by 19% (n = 22) in the extension study. HCV reinfection was observed in 3 participants. Over 246 person-years of follow-up, the incidence of reinfection was 1.22/100 person-years (95% CI, 0.25–3.57). All reinfections occurred among participants reporting ongoing IDU. The incidence of reinfection in participants reporting ongoing IDU (41 person-years of follow-up) was 7.4/100 person-years (95% CI, 1.5–21.6). Reinfection was associated with reporting ongoing IDU in the follow-up period (P < .001), a lack confidence in the ability to avoid contracting HCV (P < .001), homelessness (P = .002), and living with a PWID (P = .007). Conclusions HCV reinfection was low overall, but more common among people with ongoing IDU following DAA therapy on OAT, as well as those who were not confident in the ability to avoid contracting HCV, homeless, or living with a PWID. Interventions to mediate these risk factors following HCV therapy are warranted.

scholarly journals Hepatitis C Resistance-Associated Substitutions Among People Who Inject Drugs Treated with Direct-Acting Antiviral-Containing Regimens

2021 ◽  
Author(s):  
Matthew J Akiyama ◽  
Lindsey Riback ◽  
Jacqueline D Reeves ◽  
Yolanda S Lie ◽  
Linda Agyemang ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Protease Inhibitor ◽  
People Who Inject Drugs ◽  
Virologic Failure ◽  
Late Relapse ◽  
Resistant Virus ◽  
Genotype 1 ◽  
Direct Acting Antivirals ◽  
Direct Acting Antiviral ◽  
Direct Acting

Abstract Background Resistance-associated substitutions (RASs) to HCV direct-acting antivirals (DAAs) can contribute to virologic failure and limit retreatment options. People who inject drugs (PWID) are at highest risk for transmission of resistant virus. We report on RASs at baseline and following virologic failure in DAA-naive and protease inhibitor-experienced PWID. Methods We sequenced the NS3/4A, NS5A, and NS5B regions from 150 PWID with genotype 1 (GT1) viruses; 128 (85.3%) GT1a, 22 (14.7%) GT1b. Results Among the 139 (92.7%) DAA-naive PWID, 85/139 (61.2%) had baseline RASs – 67/139 (48.2%) in NS3 (predominantly Q80K/L); 25/139 (18.0%) in NS5A; and 8/139 (5.8%) in NS5B. Of the 11 protease inhibitor-experienced participants, 9 had baseline NS3 RASs (V36L N=1, Q80K N=9) and 4 had baseline NS5A RASs (M28V N=2, H58P N=1, A92T N=1). Among the 11 participants who had post-treatment samples with detectable virus (seven treatment failures, one late relapse, three reinfections), one sofosbuvir/ledipasvir failure had a baseline H58P. Two sofosbuvir/ledipasvir-treated participants developed new NS5A mutations (Q30H, Y93H, L31M/V). Otherwise, no RASs were detected. Conclusion Our results demonstrate RAS prevalence among DAA-naive PWID is comparable to that in the general population. Only 2/150 (1.3%) in our longitudinal cohort developed treatment-emergent RASs. Concern for transmission of resistant virus may therefore be minimal.

scholarly journals Tu1506 – Adherence to Follow-Up of People Who Inject Drugs (PWID) After the Successful Treatment of Chronic Hepatitis C with Direct-Acting Antivirals (DAA)

2019 ◽  
Vol 156 (6) ◽  
pp. S-1346
Author(s):  
KANELLOS-RAFAIL KOUSTENIS ◽  
EVANGELIA KOUTLI ◽  
Hariklia Kranidioti ◽  
PINELOPI ANTONAKAKI ◽  
PARIS PANTSAS ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Successful Treatment ◽  
People Who Inject Drugs ◽  
Direct Acting Antivirals ◽  
Direct Acting

scholarly journals In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis C in Turkey

2021 ◽  
Author(s):  
Figen Sarigul ◽  
Ülkü Üser ◽  
Didem Sarı ◽  
Behice Kurtaran ◽  
Yusuf Önlen ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Treatment Response ◽  
People Who Inject Drugs ◽  
Real Life ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Real Life Setting ◽  
Number Of Patients ◽  
Direct Acting

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

scholarly journals Hepatitis C Virus Treatment Access Among Human Immunodeficiency Virus and Hepatitis C Virus (HCV)-Coinfected People Who Inject Drugs in Guangzhou, China: Implications for HCV Treatment Expansion

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Carissa E. Chu ◽  
Feng Wu ◽  
Xi He ◽  
Kali Zhou ◽  
Yu Cheng ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Social Workers ◽  
People Who Inject Drugs ◽  
Hiv Treatment ◽  
Direct Acting Antivirals ◽  
Hcv Treatment ◽  
Treatment Access ◽  
Immunodeficiency Virus ◽  
Direct Acting

Abstract Background.  Hepatitis C virus (HCV) treatment access among human immunodeficiency virus (HIV)/HCV-coinfected people who inject drugs is poor, despite a high burden of disease in this population. Understanding barriers and facilitators to HCV treatment uptake is critical to the implementation of new direct-acting antivirals. Methods.  We conducted in-depth interviews with patients, physicians, and social workers at an HIV treatment facility and methadone maintenance treatment centers in Guangzhou, China to identify barriers and facilitators to HCV treatment. We included patients who were in various stages of HCV treatment and those who were not treated. We used standard qualitative methods and organized data into themes. Results.  Interview data from 29 patients, 8 physicians, and 3 social workers were analyzed. Facilitators and barriers were organized according to a modified Consolidated Framework for Implementation Research schematic. Facilitators included patient trust in physicians, hope for a cure, peer networks, and social support. Barriers included ongoing drug use, low HCV disease knowledge, fragmented reimbursement systems, HIV exceptionalism, and stigma. Conclusions.  Expanding existing harm reduction programs, HIV treatment programs, and social services may facilitate scale-up of direct-acting antivirals globally. Improving integration of ancillary social and mental health services within existing HIV care systems may facilitate HCV treatment access.

scholarly journals Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3414
Author(s):  
Hye Won Lee ◽  
Dai Hoon Han ◽  
Hye Jung Shin ◽  
Jae Seung Lee ◽  
Seung Up Kim ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pegylated Interferon ◽  
Direct Acting Antivirals ◽  
Treatment Regimens ◽  
Direct Acting ◽  
Similar Risk ◽  
Carcinoma Risk

By pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any difference in prognosis depending on regimens—PegIFN or DAAs. We compared the probabilities of hepatocellular carcinoma (HCC) development between patients achieving an SVR by PegIFN/ribavirin (PegIFN group, n = 603) and DAAs (DAAs group, n = 479). The DAAs group was significantly older and had a higher proportion of cirrhosis than the PegIFN group. Before adjustment, the DAAs group had a higher HCC incidence than the PegIFN group (p < 0.001). However, by multivariate analyses, the DAAs (vs. PegIFN) group was not associated with HCC risk (adjusted hazard ratio 0.968, 95% confidence interval 0.380–2.468; p = 0.946). Old age, male, higher body mass index, cirrhosis, and lower platelet count were associated with increased HCC risk (all p < 0.05). After propensity score matching (PSM), a similar HCC risk between the two groups was observed (p = 0.372). We also compared HCC incidences according to sofosbuvir (SOF)-based and SOF-free DAAs, showing a similar risk in both groups before adjustment (p = 0.478) and after PSM (p = 0.855). In conclusion, post-SVR HCC risks were comparable according to treatment regimens; PegIFN- vs. DAA-based regimens and SOF-based vs. SOF-free DAA regimens. Further studies with a longer follow-up period are required.

scholarly journals Hepatitis C Resistance-Associated Variants Among People Who Inject Drugs Treated With Direct-Acting Antiviral-Containing Regimens

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Matthew Akiyama ◽  
Jacqueline Reeves ◽  
Yolanda Lie ◽  
Linda Agyemang ◽  
Alain Litwin
Keyword(s):  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Direct Acting Antiviral ◽  
Direct Acting
Sign in / Sign up

Export Citation Format

Share Document