scholarly journals Care Facilitation Advances Movement Along The Hepatitis C Care Continuum For Persons With Hiv, Hepatitis C And Substance Use: A Randomized Clinical Trial (Ctn-0064)

2021 ◽  
Author(s):  
Lisa R Metsch ◽  
Daniel J Feaster ◽  
Lauren K Gooden ◽  
Carmen Masson ◽  
David C Perlman ◽  
...  
Keyword(s):  
Substance Use ◽  
Viral Load ◽  
Hepatitis C ◽  
Controlled Trial ◽  
Sustained Viral Response ◽  
Hiv Care ◽  
Control Group ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Viral Response

Abstract Background Direct-acting antivirals can cure HCV. Persons with HCV/HIV and living with substance use are disadvantaged in benefitting from advances in HCV treatment. Methods In this randomized controlled trial, participants with HCV/HIV were randomized between February 2016 and January 2017 to either care facilitation or control. Twelve-month follow-up assessments completed in January 2018. Care facilitation group participants received motivation and strengths-based case-management addressing retrieval of HCV load results, engagement in HCV/HIV care and medication adherence. Control group participants received referral to HCV evaluation and an offer of assistance in making care appointments. Primary outcome was number of steps achieved along a series of 8 clinical steps (e.g., receiving HCV results, initiating treatment, sustained viral response) of the HCV/HIV care continuum over 12 months post-randomization. Results Three hundred and eighty-one individuals were screened and 113 randomized. Median age was 51 years; 58.4% male and 72.6% Black/African American. Median HIV-1 viral load was 27,209 copies/ml with 69% having a detectable viral load. Mean number of steps completed was statistically significantly higher in the intervention (2.44 steps) vs. control group (1.68 steps) [χ 2(1)=7.36, p=0.0067]. Men in the intervention (vs. control) group completed a statistically significantly higher number of steps. Eleven participants achieved sustained viral response with no difference by treatment group. Conclusions The care facilitation intervention increased progress along the HCV/HIV care continuum, as observed for men and not women. Study findings also highlight the continued challenges to achieve individual patient sustained viral responses and population level HCV elimination.

scholarly journals OPPORTUNITIES AND PROSPECTS FOR INCORPORATING A THIRD DRUG TO THE TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS C

2013 ◽  
Vol 18 (5) ◽  
pp. 9-14
Author(s):  
T. V Sologub ◽  
V. V Tsvetkov ◽  
E. G Deeva ◽  
I. I Tokin
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Clinical Symptoms ◽  
Sustained Viral Response ◽  
Control Group ◽  
Genotype 1 ◽  
Viral Response ◽  
Hcv Genotype 1

In order to evaluate the efficiency and safety of using the drug Ingaron in treatment ofpatients with chronic hepatitis C (CHC) an open, randomized, control comparative study has been performed. We examined of 132 CHC patients aged from 18 to 58 years. All patients were selected into 3 groups depending on the type of therapy. The following drugs: Ribavirin, Alfarona, Ingaron were included in regimens of therapy. The course of the disease in examined CHC patients was characterized by mild clinical symptoms, the presence of the expressed cytolytic syndrome more than in half of the patients (50.8%), high levels of «viral load» in 61.6% of patients with the establishment of a direct correlation between high ALT and viremia levels (r=+0,67). The average level of «viral load» in patients infected with no-1 genotype of hepatitis C, at the start of therapy was 1,4 times higher than in those with genotype 1, amounting to 1,8 x 106 and 1,3 x 106 IU/ml, respectively. Patients infected with HCV genotype 1 and receiving therapy with Ingaron for 24 and 12 weeks, achieved sustained viral response in 65,0% and 80,0% of cases whereas patients infected with «no 1» genotype - in 73,9%, and 84,6% of cases, respectively. At the same time, in patients from the control group the sustained viral response was observed only in 56,0% and 60,0% of cases (1 and «no 1» genotypes, respectively). The inclusion of Ingaron into the classical medical regimen was accompanied by a reduction in the incidence of adverse reactions during treatment.

Importance of HIV Care Continuum

2020 ◽  
pp. 50-67
Author(s):  
Simon George Taukeni ◽  
Eveline Ndinelao Kalomo
Keyword(s):  
Viral Load ◽  
Research Direction ◽  
Cultural Barriers ◽  
Hiv Care ◽  
Future Research ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Hiv Counseling ◽  
Care Continuum ◽  
Counseling And Testing

This chapter seeks to create further awareness and public health education on the importance of the human immunodeficiency virus (HIV) care continuum as one of the key policy focal areas to significantly reduce the HIV epidemic. Specific efforts were directed into the need to implement comprehensive HIV care continuum. The chapter argues that rolling out HIV counseling and testing, enrolled and linked patients to care, prescribing antiretroviral therapy, viral load testing and monitoring are key to achieve viral load suppression. Recommendations and future research direction have put much emphasis on an effort to address psychosocial factors such as stigma, inadequate healthcare facilities, laboratory testing equipment, social and cultural barriers to testing and treatment, to improve access and overall implementation of HIV care continuum.

scholarly journals Trends of Liver Stiffness in Inflammatory Bowel Disease with Chronic Hepatitis C

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1037
Author(s):  
Giuseppe Losurdo ◽  
Andrea Iannone ◽  
Antonella Contaldo ◽  
Michele Barone ◽  
Enzo Ierardi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Hepatitis C ◽  
Bowel Disease ◽  
Antiviral Treatment ◽  
Sustained Viral Response ◽  
Liver Stiffness ◽  
Control Group ◽  
Viral Response ◽  
Inflammatory Bowel ◽  
One Year

Concomitant inflammatory bowel disease (IBD) and hepatitis C virus (HCV) infection is a relevant comorbidity since IBD itself exposes to a high risk of liver damage. We aimed to evaluate liver stiffness (LS) in IBD-HCV after antiviral treatment. We enrolled IBD patients with HCV. All patients at baseline underwent LS measurement by elastography. Patients who were eligible for antiviral therapy received direct antiviral agents (DAAs) and sustained viral response was evaluated at the 12th week. A control group was selected within IBD patients without HCV. One year later, all IBD-HCV patients and controls repeated LS measurement. Twenty-four IBD-HCV patients and 24 IBD controls entered the study. Only twelve out of 24 received DAAs and all achieved sustained viral response (SVR). All IBD subjects were in remission at enrollment and maintained remission for one year. After one year, IBD patients who eradicated HCV passed from a liver stiffness of 8.5 ± 6.2 kPa to 7.1 ± 3.9, p = 0.13. IBD patients who did not eradicate HCV worsened liver stiffness: from 7.6 ± 4.4 to 8.6 ± 4.6, p = 0.01. In the IBD control group, stiffness decreased from 7.8 ± 4.4 to 6.0 ± 3.1, p < 0.001. In conclusion, HCV eradication is able to stop the evolution of liver fibrosis in IBD, while failure to treat may lead to its progression. A stable IBD remission may improve LS even in non-infected subjects.

scholarly journals HIV Care Continuum from diagnosis in a Counseling and Testing Center

2020 ◽  
Vol 73 (6) ◽  
Author(s):  
Angélica da Mata Rossi ◽  
Silvia Paulino Ribeiro Albanese ◽  
Ingridt Hildegard Vogler ◽  
Flávia Meneguetti Pieri ◽  
Edvilson Cristiano Lentine ◽  
...  
Keyword(s):  
Viral Load ◽  
Retention In Care ◽  
Late Diagnosis ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Care Continuum ◽  
Counseling And Testing ◽  
Testing Center ◽  
Hiv Aids

ABSTRACT Objective: To analyze the HIV care continuum from the diagnosis in an HIV/AIDS Counseling and Testing Center (CTC), and the sociodemographic, clinical, and laboratory characteristics related to gender. Method: Epidemiological study, conducted with data of individuals assisted at a Counseling and Testing Center, and followed in an outpatient clinic for HIV/AIDS. Pearson’s Chi-square test and binary logistic regression were used to obtain odds ratios, considering alpha value <0.05. Results: The prevalence of HIV among 5,229 users was 5%. The highest chance of positive results was among men, aged 14 to 33 years old, who were not in a domestic partnership. In the analysis of TCD4+ lymphocytes and viral load (VL) of 238 cases, 56.1% had a late diagnosis. We have identified gaps in the care cascade, especially linkage to the care, retention in care, and viral load suppression. Conclusion: The results suggest a late diagnosis for both genders, as well as difficulty in reaching the viral suppression goal.

scholarly journals 1312. Increasing Care Engagement Amongst People Living with HIV Through a Text Messaging Intervention at a Tertiary Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S473-S474
Author(s):  
Nupur Gupta ◽  
Sarah McBeth ◽  
Ella Kaplan ◽  
Greg Valdisera ◽  
Deborah McMahon
Keyword(s):  
Viral Load ◽  
Text Messaging ◽  
Chart Review ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Tertiary Center ◽  
Risk Patients ◽  
Living With Hiv

Abstract Background HIV has transitioned from an acute illness to a chronic disease due to potent antiretroviral therapy (ART). People living with HIV (PLWH) must be highly compliant which is difficult due to multiple barriers. The HIV care continuum was developed as a series of steps that PLWH take in their treatment cascade. At our HIV clinic, 90% of the patients are virally suppressed (viral load <200 copies/mL). Although this is higher than the national average, PLWH who are not virally suppressed and not retained in care carry the highest risk of transmission. We have several resources to engage patients, but text messaging has not been utilized for at-risk patients at the clinic or at the academic center. Methods The aim is to demonstrate that a pilot study of a text messaging-based intervention will increase the proportion of PLWH along the care continuum. The pre-intervention data consists of the clinic population with a viral load ≥200 copies/mL between July 1, 2017 and June 30, 2018. After chart review, eligible patients were consented to receive weekly text messages with content regarding appointment and medication reminders, and motivational messages. In the consented group, effectiveness of the intervention will be measured by tracking their appointments, viral loads, and ART prescriptions. Results After chart review, 80 patients were eligible, and 18 patients were consented for the intervention. In the eligible group, the average length of care is 8 years (range 0 to 26) and average number of years since initial ART prescription is 6.8 (range 0 to 20). The average viral load is 27,372 copies/mL. Amongst the consented group (n = 18), compared with the pre-intervention, there was a 6% increase in those who made an appointment, 33% increase in those who kept an appointment, 50% increase in those who had a viral load <200, and 62% increase in those who had ART dispensed post-intervention. Conclusion The intervention group is small due to difficulties in consenting this vulnerable population. This is an observational study that demonstrated the impact of text messaging a high-risk population with minimal harm that not only improved the local HIV care continuum, but also addressed the barriers to care. The next steps are to determine how this method can link other at-risk patients to care at a large HIV clinic at a tertiary center. Disclosures All authors: No reported disclosures.

scholarly journals Exploring How Substance Use Impedes Engagement along the HIV Care Continuum: A Qualitative Study

2016 ◽  
Vol 4 ◽  
Author(s):  
Marya Gwadz ◽  
Rebecca de Guzman ◽  
Robert Freeman ◽  
Alexandra Kutnick ◽  
Elizabeth Silverman ◽  
...  
Keyword(s):  
Substance Use ◽  
Qualitative Study ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum
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