Bajis, Sahar, Grebely, Jason, Hajarizadeh, Behzad, Applegate, Tanya, Marshall, Alison D., Harrod, Mary Ellen, Byrne, Jude, Bath, Nicky, Read, Phillip, Edwards, Michael, Gorton, Carla, Hayllar, Jeremy, Cock, Victoria, Peterson, Steven, Thomson, Claire, Weltman, Martin, Jefferies, Meryem, Wood, William, Haber, Paul, Ezard, Nadine, Martinello, Marianne, Maher, Lisa, Dore, Gregory J., and LiveRLife Study Group (2020) 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. Journal of Viral Hepatitis, 27 (3). pp. 281-293.

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Abstract

Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treat-ment 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 unre-stricted 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) re-ported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had de-tectable 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 associ-ated 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

Item ID:	81166
Item Type:	Article (Research - C1)
ISSN:	1365-2893
Keywords:	cascade of care, direct-acting antiviral, hepatitis C virus, linkage to care, treatment uptake
Copyright Information:	© 2019 John Wiley & Sons Ltd
Additional Information:	Michelle Micallef is part of the LiveRLife Study Group. All collaborators are listed at the end of the article
Funders:	National Health and Medical Research Council (NHMRC)
Projects and Grants:	NHMRC grant number APP1103165, NHMRC Career Development Fellowship, NHMRC Senior Research Fellowship, NHMRC Early Career Fellowship, NHMRC Practitioner Research Fellowship
Date Deposited:	27 Nov 2023 23:24
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50% 42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 50%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 30% 20 HEALTH > 2003 Provision of health and support services > 200303 Health surveillance @ 30% 20 HEALTH > 2003 Provision of health and support services > 200302 Community health care @ 40%
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