scholarly journals DIFERENCIAS EN EL ACCESO Y EN EL TIEMPO HASTA EL INICIO DE TRATAMIENTO HEPATITIS C EN PERSONAS CON DESORDENES DE SALUD MENTAL

2021 ◽  
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Linkage To Care ◽  
Mental Health Disorder ◽  
Additive Models ◽  
Unique Challenge ◽  
Direct Acting Antiviral ◽  
Salud Mental ◽  
Vulnerable Subpopulations ◽  
Direct Acting

People who inject drugs (PWID) and other marginalized populations with high hepatitis C virus (HCV) infection rates represent a unique challenge for treatment initiation due to health, administrative and social barriers. We analyzed the HCV cascade of care (CoC) in some vulnerable subpopulations in Madrid, Spain, when using a mobile point of care. to identify gaps and barriers to improve HCV elimination efforts in these populations. Methods: From 2019 to 2021, a mobile unit was used to screen for HCV using a linkage-to-care and two-step point-of-care-based strategy. Viremic participants were grouped into four subgroups: PWID, homeless individuals, people with a mental health disorder (MHD) and people with alcohol use disorder (AUD). Logistic regression and Cox and Aalen’s additive models were used to analyze associated factors and differences between groups. Results: A prospectively recruited cohort of 214 HCV infected individuals (73 PWID, 141 homeless, 57 with a MHD and 91 with AUD) participated in the study. The overall HCV CoC analysis found that: 178 (83.1%) attended a hospital, 164 (76.6%) initiated direct-acting antiviral therapy and 141 (65.8%) completed therapy, of which 99 (95.2%) achieved a sustained virological response (SVR). PWID were significantly less likely to initiate treatment, while individuals with AUD waited longer before starting treatment. Both people with AUD and PWID were significantly less likely to complete HCV treatment. Conclusions: Overall, SVR was achieved in the majority of the participants treated. However, PWID need better linkage to care and treatment, while PWID and AUD need more support for treatment completion.

scholarly journals Disparities in Hepatitis C Linkage to Care in the Direct Acting Antiviral Era: Findings From a Referral Clinic With an Embedded Nurse Navigator Model

2019 ◽  
Vol 7 ◽  
Author(s):  
Jacqueline E. Sherbuk ◽  
Kathleen A. McManus ◽  
Terry Kemp Knick ◽  
Chelsea E. Canan ◽  
Tabor Flickinger ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Linkage To Care ◽  
Direct Acting Antiviral ◽  
Nurse Navigator ◽  
Direct Acting

scholarly journals 2899. Decreased Hepatitis C Virus-Associated Mortality in the US 2014–2017 After New Oral Direct-Acting Antiviral Era

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S82-S83
Author(s):  
Zainab Wasti ◽  
Dagan Coppock ◽  
Edgar Chou ◽  
Dong Heun Lee
Keyword(s):  
United States ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Linkage To Care ◽  
The United States ◽  
Ease Of Use ◽  
Hcv Infection ◽  
Race And Gender ◽  
Direct Acting Antiviral ◽  
Direct Acting

Abstract Background Due to the ease of use and low side effect profile of new direct-acting antivirals (DAA), cure rates for hepatitis C virus (HCV) infection have increased in recent years. However, limited data exist addressing the mortality associated with HCV infection since the advent of DAAs. This study examines multiple-cause-of-death (MCOD) data from 2014 to 2017 to describe changes in HCV-associated mortality in the United States. Methods We examined death certificate information from public use MCOD data obtained from the National Center for Health Statistics. All-cause mortality associated with HCV, as defined by ICD-10 codes (B17.1 and B18.2), was evaluated. The age-adjusted crude mortality rate was calculated. Overall HCV-associated mortality, stratified by race and gender, was analyzed. Results From 2014 to 2017, the number of deaths associated with HCV, as listed in death certificates decreased from 19,613 to 17,253. This represents an average of 4% decrease in mortality each year. Crude age-adjusted mortality decreased from 5.01 (95% CI 4.93–5.08) deaths per 100,000 people in 2014 to 4.13 (95% CI 4.07–4.20) deaths per 100,000 people in 2017. Males had age-adjusted mortality of 6.82 (95% CI 6.76–6.88) and females had age-adjusted mortality of 2.59 (95% CI 2.55–2.63). African Americans had age-adjusted mortality of 7.50 (95% CI 7.37–7.63), and whites had age-adjusted mortality of 4.39 (95% CI 4.35–4.42) during the three-year period. Conclusion After the introduction of DAAs in 2014, mortality associated with HCV significantly decreased in the United States. There were differences in mortality rates by gender and race, which may reflect differences in HCV seroprevalence. With the availability of effective, well-tolerated HCV treatment, aggressive HCV screening and linkage to care is warranted, especially in high-risk populations. Disclosures All Authors: No reported Disclosures.

scholarly journals Simplification of Care for Chronic Hepatitis C Virus Infection

2020 ◽  
Vol 40 (04) ◽  
pp. 392-402 ◽  
Author(s):  
Jean-Michel Pawlotsky ◽  
Christian B. Ramers ◽  
John F. Dillon ◽  
Jordan J. Feld ◽  
Jeffrey V. Lazarus
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Scale Up ◽  
Linkage To Care ◽  
World Health ◽  
Direct Acting Antiviral ◽  
Hcv Screening ◽  
Health Organization ◽  
Chronic Hcv ◽  
Direct Acting

AbstractIn 2016, the World Health Organization (WHO) set a target for eliminating viral hepatitis as a major public health threat by 2030. However, while today's highly effective and well-tolerated pangenotypic direct-acting antiviral regimens have maximized simplification of hepatitis C virus (HCV) treatment, there remain a plethora of barriers to HCV screening, diagnosis, and linkage to care. As of 2017, only 19% of the estimated 71 million individuals living with chronic HCV worldwide were diagnosed and in 2015 to 2016, only 21% of diagnosed individuals had accessed treatment. Simplification and decentralization of the HCV care cascade would bolster patient engagement and support the considerable scale-up needed to achieve WHO targets. Recent developments in HCV screening and diagnosis, together with reduced pretreatment assessment and on-treatment monitoring requirements, can further streamline the care continuum, ensuring patients are linked to care quickly and earlier in the disease course, and minimize clinic visits.

scholarly journals Improved Hepatitis C Cure Cascade Outcomes Among Urban Baby Boomers in the Direct-Acting Antiviral Era

2019 ◽  
Vol 135 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Sarah C. Dupont ◽  
Shelly-Ann Fluker ◽  
Kristi M. Quairoli ◽  
Cameron Body ◽  
Ike Okosun ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Treatment ◽  
Linkage To Care ◽  
Newly Diagnosed ◽  
Screening Programs ◽  
Direct Acting Antiviral ◽  
Treatment Uptake ◽  
Period 2 ◽  
Direct Acting ◽  
Cure Rates

Objectives: We compared outcomes of the hepatitis C virus (HCV) cure cascade (ie, the path a patient follows from diagnosis to cure), including antiviral treatment outcomes, from 2 HCV screening programs. Our objective was to assess whether treatment uptake and HCV cure rates improved in the cohort screened after the release of all-oral HCV direct-acting antiviral therapies. Methods: We retrospectively compared outcomes of the HCV cure cascade from a cohort of newly diagnosed patients screened during 2012-2014 (period 1) with outcomes from a cohort of newly diagnosed patients screened during 2015-2016 (period 2) at Grady Health System in Atlanta, Georgia. Cure cascade outcomes included HCV antibody (anti-HCV) and RNA testing, linkage to care, antiviral treatment, and sustained virologic response. Results: During period 1, 412 of 5274 (7.8%) persons screened were anti-HCV positive, and 264 (69.3%) of those tested were RNA positive. During period 2, 462 of 7137 (6.5%) persons screened were anti-HCV positive, and 240 (59.3%) of those tested were RNA positive ( P = .003). The percentage of newly diagnosed patients who were treated during period 2 (64.0%) was 3 times that of newly diagnosed patients treated during period 1 (21.2%; P < .001). Both cohorts had similarly high levels of linkage to care (95.8% during period 1, 95.4% during period 2) and cure (92.6% during period 1, 95.5% during period 2). Conclusions: Over time, the prevalence of anti-HCV and HCV RNA positivity declined substantially, and linkage-to-care and cure rates remained high. Treatment uptake increased significantly after the introduction of all-oral direct-acting antiviral therapy. These findings suggest that combining large-scale screening initiatives with treatment programs can speed progress toward HCV elimination.

New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania

2017 ◽  
Vol 26 (4) ◽  
pp. 381-386
Author(s):  
Mircea Manuc ◽  
Carmen M. Preda ◽  
Corneliu P. Popescu ◽  
Cristian Baicuș ◽  
Theodor Voiosu ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Users ◽  
Antiviral Agent ◽  
Virologic Response ◽  
Advanced Fibrosis ◽  
Direct Acting Antiviral ◽  
Genotype 1B ◽  
Direct Acting ◽  
End Stage

Background & Aims: Literature data suggest that HCV genotype-1b is present in 93-99% of the Romanian patients infected with hepatitis C virus (HCV). We present the genotyping tests recently performed on patients with HCV and advanced fibrosis eligible for the Direct-Acting Antiviral (DAA) therapy, as well as the prevalence of these cases across Romania.Methods: The genotyping method was performed on 7,421 HCV patients with advanced fibrosis. The detection method was automatic real time PCR platform M2000 (Abbott). Every subject was introduced into a database including age, sex, county and address.Results: Genotype 1b was almost exclusively present: 7,392/7,421 (99.6%). Genotype 1b patients were 19.6% from Bucharest, 49% were males, with a median age of 60 years. Genotype non-1b was encountered in 29/7,421 subjects (0.4%), 62% were males, 69% from Bucharest and the median age was 52 years. Most of the subjects (75%) were in the 6th and 7th age decade. The prevalence of these cases varied significantly across Romanian counties: the highest was in Bucharest (61.3/105), Bihor (47/105), Iasi (46/105) and Constanța (43/105), and the lowest in Ilfov (2.8/105), Harghita (3.7/105), Covasna (5.4/105) and Maramureș (8.8/105) (p<0.001).Conclusions: Genotype 1b is encountered in 99.6% of patients with chronic hepatitis C and advanced fibrosis from Romania. The presence of genotypes non-1b is more common in Bucharest, in males and at a younger age. There are significant differences regarding the distribution of these cases across Romania: the highest rates are in Bucharest, Bihor, Iasi and Constanta.Abbreviations: BMI: body mass index; DAA: direct-acting antiviral agent; GT: genotype; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; IDU: intravenous drug users; MELD: model for end stage liver disease; NASH: non-alcoholic steatohepatitis; SVR; sustained virologic response.

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