Implementing and scaling up HCV treatment services for people who inject drugs and other high risk groups in Ukraine: An evaluation of programmatic and treatment outcomes

Background: Viral hepatitis is a serious public health problem affecting billions of people globally. The Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are blood borne pathogens, frequently causing deaths among general and various high risk populations. This study was carried out with the aim to determine the seroprevalence of HBV and HCV in people who inject drugs (PWID) and other risk groups. Methods: A cross-sectional study carried out in the Dept. of Microbiology, RIMS, Imphal from October 2014 to September 2016. 103 high risk individuals, including PWID, spouse of high risk people, unprotected sex with female sex worker (FSW), multiple partners (MP), men having sex with men (MSM) and needle prick injuries were included in this study. Serum samples were tested using Enzyme linked immunosorbent assay (ELISA). Results: Out of 103 cases, 87.4% were males and 12.6% females. PWID comprised of 49.5%. Seroprevalence of HBV was 17.4%, anti HBc IgG 16.5% and anti HBc IgM 0.9%. Seroprevalence of HCV was 41.7%, anti HCV IgG 39.8% and anti HCV IgM 1.9%. The rate of HBV and HCV coinfection was 9.7%. Among the PWID seroprevalence of HBV and HCV was 17.6% and 64.7% respectively. Conclusions: This study determines the current status of acute and chronic infection with HBV and HCV in high risk populations. Anti HBc IgG & IgM and anti HCV IgG and IgM are sensitive epidemiological markers to determine the burden of the disease.

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904. Improving Infectious Disease Screening and Hepatitis C Care Cascade Outcomes Among Adults Receiving Medication Assisted Treatment

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1099 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S543-S544

Author(s):

Sarah Hoehnen ◽

Audra B Blood ◽

Rachel Austermiller

Keyword(s):

Treatment Outcomes ◽

People Who Inject Drugs ◽

Published Data ◽

Hiv Screening ◽

Hcv Treatment ◽

Medication Assisted Treatment ◽

Care Cascade ◽

Opt Out ◽

Hcv Screening ◽

One Year

Abstract Background This initiative increased infectious disease (ID) screening in an adult medication assisted treatment (MAT) population at a Federally Qualified Health Center (FQHC) by implementing opt-out screening for HIV, viral hepatitis, and sexually transmitted infections (STIs), and assessed the success of a co-located hepatitis C (HCV) treatment program. Methods ID providers maintained a standing lab order for HIV, hepatitis A, hepatitis B, HCV, syphilis, chlamydia/gonorrhea (GC/CT), and trichomoniasis (trich), with reflex to confirmatory for HIV/HCV/syphilis. For all existing and new adult MAT patients, a MAT RN provided education, ensured lab draw on the day of MAT induction, and scheduled an ID follow-up visit. The patient then had an in-person or telemedicine visit with the ID provider to review results, discuss risk reduction, and initiate treatment (HIV PrEP or treatment for STI, HCV, or HIV) as indicated. Data was compiled and monitored by a Prevention RN. Plan, Do, Study, Act (PDSA) Model PDSA model demonstrating implementation approach Results The rate of testing among MAT patients increased over a one-year period. HCV treatment uptake in this setting exceeded that documented in published data for people who inject drugs (PWID). HCV Care Cascade Outcomes HCV screening and treatment outcomes within HCV Care Cascade model Screening Outcomes Screening rates among adult MAT population over a one-year measurement period Conclusion This study documents the successful implementation of an opt-out screening program among an adult substance use disorder (SUD) treatment population across urban, mixed, and designated rural environments. HCV treatment uptake in this setting exceeded that documented in published data for people who inject drugs (PWID). Barriers to implementation included acceptance among patients with long-term MAT participation, acceptance/adoption by behavioral health nursing and provider staff, and functional workflow development – establishment of protocol, lab availability, scheduling, and “tough sticks.” Modifications that increased effectiveness included an interdisciplinary approach and dedicated staff for monitoring results completion and patient outreach. Run chart: HIV screening rates over a one-year period HIV screening change among adult MAT patients over a one-year period Run chart: HCV screening rates over a one-year period HCV screening change among adult MAT patients over a one-year period HCV Care Cascade: HCV screening and treatment outcomes HCV screening and treatment outcomes presented in HCV Care Cascade for adult MAT population Disclosures All Authors: No reported disclosures

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Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

BMC Infectious Diseases ◽

10.1186/s12879-020-05667-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Irene Pericot-Valverde ◽

Moonseong Heo ◽

Matthew J. Akiyama ◽

Brianna L. Norton ◽

Linda Agyemang ◽

...

Keyword(s):

Clinical Trial ◽

Cigarette Smoking ◽

Treatment Outcomes ◽

Randomized Clinical Trial ◽

People Who Inject Drugs ◽

Treatment Completion ◽

Hcv Treatment ◽

Opioid Agonist ◽

Cocaine Use ◽

High Prevalence

Abstract Background Cigarette smoking has emerged as a leading cause of mortality among people with hepatitis C virus (HCV). People who inject drugs (PWID) represent the largest group of adults infected with HCV in the US. However, cigarette smoking remains virtually unexplored among this population. This study aimed at (1) determining prevalence and correlates of cigarette smoking among HCV-infected PWID enrolled in opiate agonist treatment programs; (2) exploring the association of smoking with HCV treatment outcomes including adherence, treatment completion and sustained virologic response (SVR); and 3) exploring whether cigarette smoking decreased after HCV treatment. Methods Participants were 150 HCV-infected PWID enrolled in a randomized clinical trial primarily designed to test three intensive models of HCV care. Assessments included sociodemographics, presence of chronic health and psychiatric comorbidities, prior and current drug use, quality of life, and HCV treatment outcomes. Results The majority of the patients (84%) were current cigarette smokers at baseline. There was a high prevalence of psychiatric and medical comorbidities in the overall sample of PWID. Alcohol and cocaine use were identified as correlates of cigarette smoking. Smoking status did not influence HCV treatment outcomes including adherence, treatment completion and SVR. HCV treatment was not associated with decreased cigarette smoking. Conclusions The present study showed high prevalence of cigarette smoking among this population as well as identified correlates of smoking, namely alcohol and cocaine use. Cigarette smoking was not associated with HCV treatment outcomes. Given the detrimental effects that cigarette smoking and other co-occurring, substance use behaviors have on HCV-infected individuals’ health, it is imperative that clinicians treating HCV also target smoking, especially among PWID. The high prevalence of cigarette smoking among PWID will contribute to growing morbidity and mortality among this population even if cured of HCV. Tailored smoking cessation interventions for PWID along with HCV treatment may need to be put into clinical practice. Trial registration NCT01857245. Registered May 20, 2013.

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The Costs of Scaling Up HIV Prevention for High Risk Groups: Lessons Learned from the Avahan Programme in India

PLoS ONE ◽

10.1371/journal.pone.0106582 ◽

2014 ◽

Vol 9 (9) ◽

pp. e106582 ◽

Cited By ~ 9

Author(s):

Sudhashree Chandrashekar ◽

Lorna Guinness ◽

Michael Pickles ◽

Govindraj Y. Shetty ◽

Michel Alary ◽

...

Keyword(s):

High Risk ◽

Hiv Prevention ◽

Risk Groups ◽

Scaling Up ◽

Lessons Learned ◽

Avahan Programme

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A mathematical modeling approach to measure the probability of HIV-1 transmission for different high-risk groups of Pakistan

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12664 ◽

2021 ◽

Vol 15 (08) ◽

pp. 1212-1215

Author(s):

Syed Rizwan-ul-Hasan ◽

Fatima Farrukh ◽

Shakil Ahmed ◽

Syed Hani Abidi

Keyword(s):

High Risk ◽

Vulnerable Populations ◽

People Who Inject Drugs ◽

Risk Group ◽

Probabilistic Modeling ◽

Risk Groups ◽

High Risk Group ◽

Intervention Strategies ◽

High Likelihood ◽

Hiv 1

Introduction: Since 2010, the number of new HIV-1 cases has declined by 30% globally, however, in few countries, such as Pakistan, the cases have continued to increase, where the country witnessed a 57% increase in the number of new infections between 2010 and 2020. The HIV-1 epidemic in Pakistan is concentrated in certain high-risk groups, however, it is unknown which high-risk group has a higher likelihood of transmitting HIV-1 infections to vulnerable populations. This study aimed to apply mathematical probabilistic modeling to estimate the probability of HIV-1 transmission for different high-risk groups of Pakistan. Methodology: MATLAB software was used to conduct probabilistic modeling (chance estimation) of HIV-1 transmission for different high-risk groups of Pakistan, and also draw a comparison between Pakistan and different high- and low- HIV-1 prevalence countries. Results: Our results revealed that Pakistan overall had the lowest probability of HIV-1 transmission as compared to other countries included in this study; however, within Pakistan, certain high-risk groups such as people who inject drugs (PWID) and the region of Larkana exhibited a high probability of HIV-1 transmissions. Conclusions: Our study suggests that the concentrated HIV-1 epidemic in Pakistan has a high likelihood of expansion from certain high-risk groups to other vulnerable populations. Further studies to understand the socio-epidemiological factors driving the expansion of the HIV-1 epidemic within the country will guide specific HIV-1 intervention strategies to control the spread of HIV-1 from high-risk to other vulnerable populations.

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Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽

10.1027//0227-5910.20.2.64 ◽

1999 ◽

Vol 20 (2) ◽

pp. 64-70 ◽

Cited By ~ 5

Author(s):

Tamás Zonda

Keyword(s):

High Risk ◽

Psychiatric Disorders ◽

Suicide Rate ◽

Risk Groups ◽

The Elderly ◽

Female Ratio ◽

Suicide Notes ◽

Suicidal Intention ◽

Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

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Latest APA Survey Reveals Deepening Concerns About Connection Between Chronic Disease and Stress: Psychologists warn of a rising public health dilemma, especially for high-risk groups

PsycEXTRA Dataset ◽

10.1037/e683522012-001 ◽

2012 ◽

Keyword(s):

Public Health ◽

Chronic Disease ◽

High Risk ◽

Risk Groups

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A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

Orvosi Hetilap ◽

10.1556/oh.2012.29329 ◽

2012 ◽

Vol 153 (17) ◽

pp. 649-654

Author(s):

Piroska Orosi ◽

Judit Szidor ◽

Tünde Tóthné Tóth ◽

József Kónya

Keyword(s):

High Risk ◽

Influenza Season ◽

National Level ◽

Organ Transplant ◽

High Risk Patient ◽

Risk Groups ◽

Health Sciences ◽

World Health ◽

Transplant Patients ◽

Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

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