scholarly journals Linkage to Hepatitis C Care Following Release from Jail: A Prospective, Single Arm Clinical Trial

2019 ◽  
Author(s):  
Matthew Jiro Akiyama ◽  
Devin Columbus ◽  
Ross MacDonald ◽  
Alison O Jordan ◽  
Jessie Schwartz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hepatitis C ◽  
Patient Navigation ◽  
Transitional Care ◽  
Public Health Problem ◽  
Linkage To Care ◽  
Virologic Response ◽  
Major Public Health Problem ◽  
Hcv Treatment ◽  
Community Healthcare

Abstract Background: Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration. Methods: We conducted a single arm clinical trial to assess the rate and factors associated with linkage to HCV care after incarceration associated with a combined transitional care coordination (TCC) and patient navigation intervention. Results: During the intervention, n=84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years (SD=12). Of those who returned to the community, 26 (31%) linked to HCV care within a mean of 29 days (SD=25); 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, and 7 (8%) had documentation of sustained virologic response. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care. Conclusion: We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement.

scholarly journals Linkage to Hepatitis C Care After Incarceration in Jail: A Prospective, Single Arm Clinical Trial

2019 ◽  
Author(s):  
Matthew Jiro Akiyama ◽  
Devin Columbus ◽  
Ross MacDonald ◽  
Alison O Jordan ◽  
Jessie Schwartz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hepatitis C ◽  
Patient Navigation ◽  
Transitional Care ◽  
Public Health Problem ◽  
Linkage To Care ◽  
Major Public Health Problem ◽  
Hcv Treatment ◽  
Community Healthcare

Abstract Background: Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration. Methods: We conducted a single arm clinical trial of a combined transitional care coordination (TCC) and patient navigation intervention and assessed the linkage rate and factors associated with linkage to HCV care after incarceration. Results: During the intervention, 84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years. Of those who returned to the community, 26 (31%) linked to HCV care within a median of 20.5 days; 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, 9 (11%) had a follow-up lab drawn to confirm sustained virologic response (SVR), and 7 (8%) had a documented SVR. Among those with follow-up labs the known SVR rate was (7/9) 78%. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care. Conclusion: We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement.

scholarly journals Linkage to Hepatitis C Care After Incarceration in Jail: A Prospective, Single Arm Clinical Trial

2019 ◽  
Author(s):  
Matthew Jiro Akiyama ◽  
Devin Columbus ◽  
Ross MacDonald ◽  
Alison O Jordan ◽  
Jessie Schwartz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hepatitis C ◽  
Patient Navigation ◽  
Transitional Care ◽  
Public Health Problem ◽  
Linkage To Care ◽  
Major Public Health Problem ◽  
Hcv Treatment ◽  
Community Healthcare

Abstract Background: Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration. Methods: We conducted a single arm clinical trial of a combined transitional care coordination (TCC) and patient navigation intervention and assessed the linkage rate and factors associated with linkage to HCV care after incarceration. Results: During the intervention, 84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years. Of those who returned to the community, 26 (31%) linked to HCV care within a median of 20.5 days; 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, 9 (11%) had a follow-up lab drawn to confirm sustained virologic response (SVR), and 7 (8%) had a documented SVR. Among those with follow-up labs the known SVR rate was (7/9) 78%. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care. Conclusion: We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement.

scholarly journals Hepatitis C testing and linkage to care among adults on probation in a large US city

2021 ◽  
Author(s):  
Kevin F Kamis ◽  
David L Wyles ◽  
Matthew S Minturn ◽  
Tracy Scott ◽  
Dean McEwen ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Linkage To Care ◽  
Virologic Response ◽  
Patient Navigator ◽  
Hcv Rna ◽  
Study Cohort ◽  
Hcv Treatment ◽  
Hiv Test ◽  
Hcv Testing

Abstract Background Despite constituting the largest segment of the correctional population, individuals on probation remain largely unstudied with respect to hepatitis C virus (HCV) testing and linkage-to-care. We implemented an HCV testing and patient navigation program at an adult probation department. Methods Adults were tested at a local probation department with a rapid point-of-care HCV antibody (Ab) assay followed by a lab-based HCV RNA assay if anti-HCV positive. All individuals received counseling rooted in harm-reduction principles. Individuals testing positive for HCV Ab were immediately linked to a patient navigator in person or via telephone. The patient navigator assisted patients through cure unless lost to follow-up. Study participation involved an optional survey and optional point-of-care HIV test. Results Of 417 individuals tested, 13% were HCV Ab positive and 65% of those tested for HCV RNA (34/52) had detectable HCV RNA. Of the 14 individuals who linked to an HCV treatment provider, 4 completed treatment as measured by pharmacy fill documentation in the electronic medical record, and 1 obtained sustained virologic response. 193 individuals tested for HIV; none tested positive. Conclusions The study cohort had a higher HCV seroprevalence than the general population (13% vs 2%), but linkage-to-care, completion of HCV treatment, and successful test-of-cure rates were all low. This study indicates that HCV disproportionately impacts adults on probation and prioritizing support for testing and linkage-to-care could improve health in this population. Co-localization of HCV treatment within probation programs would reduce the barrier of attending a new institution and could be highly impactful.

scholarly journals Hepatitis C Treatment Outcomes for People Who Inject Drugs Treated in an Accessible Care Program Located at a Syringe Service Program

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Benjamin J Eckhardt ◽  
Matthew Scherer ◽  
Emily Winkelstein ◽  
Kristen Marks ◽  
Brian R Edlin
Keyword(s):  
Public Health ◽  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Public Health Problem ◽  
Care Program ◽  
Virologic Response ◽  
Hcv Treatment ◽  
Service Program ◽  
Significant Public Health Problem ◽  
Significant Public Health

Abstract Hepatitis C virus (HCV) is a significant public health problem that disproportionately afflicts people who inject drugs. We describe outcomes of HCV treatment co-located within a syringe services program (SSP). Fifty-three participants started therapy, and 91% achieved sustained virologic response. SSPs provide an effective venue for HCV treatment.

scholarly journals 297. Accessible Care Intervention for Engaging People Who Inject Illicit Drugs in Hepatitis C Virus Care: Preliminary Results from a Randomized Clinical Trial

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S161-S161
Author(s):  
Benjamin Eckhardt ◽  
Yesenia Aponte-Meledez ◽  
Chunki Fung ◽  
Shashi Kapadia ◽  
La Davis ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hepatitis C ◽  
Usual Care ◽  
Randomized Clinical Trial ◽  
Illicit Drugs ◽  
Treatment Initiation ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Service Program ◽  
Care Intervention

Abstract Background To achieve hepatitis C elimination, treatment programs need to be developed to engage, treat, and cure people who are actively injecting drugs. Methods We present preliminary data from the first 65 participants in the Accessible Care intervention for engaging people who inject illicit drugs (PWID) in hepatitis C (HCV) care. The randomized clinical trial compares the effectiveness of Accessible Care (low-threshold care in a syringe service program located in New York City) with Usual Care (referral to existing services) in facilitating linkage, engagement, and retention in HCV care. Eligible participants were HCV RNA positive and had injected drugs in the past 90 days. We compared the percentage of participants in each arm linked to HCV care (defined as one visit with HCV treatment provider), and initiated direct-acting antiviral (DAA) treatment within 6 months of enrollment. Results Among the 65 participants, the mean age is 41.2 years; 28% are females; 73% homeless; 6% black, 51% Latina/o and 39% white. 82% of participants had injected drugs in the last 30 days, with an average of 13.2 injections/month (median 10). Nearly all participants had health insurance, 88% public insurance, 6% uninsured. Thirty-two participants were randomized to the Accessible Care arm. Within 6 months of enrollment 79% of the Accessible Care arm and 25% of the Usual Care arm had linked to HCV care, and 69% and 13% had been started on DAA therapy, respectively. Of the 26 participants in the Accessible Care arm started on DAA therapy, the median time from enrollment to treatment initiation was 87.5 days [range 22–180]. Conclusion Among HCV-infected PWID enrolled at a syringe service program, higher rates of linkage to care and treatment initiation were seen in the Accessible Care arm where stigma- and shame-free treatment was located within a community-based location. Disclosures All authors: No reported disclosures.

scholarly journals A Hepatitis C Educational Needs Assessment of Canadian Healthcare Providers

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Reza Naghdi ◽  
Karen Seto ◽  
Carolyn Klassen ◽  
Didi Emokpare ◽  
Brian Conway ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Needs Assessment ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Public Health Problem ◽  
Primary Care Providers ◽  
Educational Needs ◽  
Major Public Health Problem ◽  
Care Providers

Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes. The survey assessed several domains (e.g., participant and practice demographics, access to resources, knowledge of new treatments, and educational preferences). Results. A total of 163 HCPs responded to the survey. All hepatologists and 8% of primary care providers (PCPs) reported involvement in treatment of CHC. Physicians most frequently screened patients who had abnormal liver enzymes, while nurses tended to screen based on lifestyle factors. More than 70% of PCPs were not aware of new medications and their mechanisms. Conclusion. Overall, the needs assessment demonstrated that there was a need for further education, particularly for primary care physicians, to maximize the role that they can play in screening, testing, and treatment of hepatitis C in Canada.

scholarly journals Efficacy and Safety of Iranian Poly Herbal Formulation (Compound Honey Syrup) in Pediatric Patients with Mild to Moderate Asthma: A Randomized Clinical Trial

2017 ◽  
Vol 6 (4) ◽  
pp. 291-301
Author(s):  
Saeed Sadr ◽  
Shahpar Kaveh ◽  
Rasool Choopani ◽  
Houman Bayat ◽  
Mahmoud Mosaddegh
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Pediatric Asthma ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Efficacy And Safety ◽  
Asthma Control Questionnaire ◽  
Moderate Asthma ◽  
Herbal Formulation ◽  
Significant Difference

Background: Asthma is a chronic relapsing airways disease that represents a major public health problem worldwide. With the high incidence of asthma, there has been a surge in the use of complementary therapies, such as compound honey syrup in Traditional Persian Medicine, in the treatment of asthma. The aim of this study was to evaluate the efficacy and safety of Iranian poly herbal formulation (compound honey syrup) in the treatment of mild to moder­ate pediatric asthma. Materials and Methods: The study was a randomized clinical trial that was conducted on 80 patients with mild to moderate asthma assigned to two groups (n=40 for each group) for eight weeks. Control and experimental groups received classical treatment of asthma with fluticasone spray; in case of worsening of symptoms, salbutamol spray was used for short term. The experimental group also received compound honey syrup (the combina­tion of honey and an extract of the following five medicinal plants: ginger, cinnamon, saf­fron, cardamom, and galangal). Asthma Control Questionnaire (ACQ) items and total scores of ACQ were evaluated before and after treatment. Results: To this end, 72 patients complet­ed this study. There was no significant difference between the experimental and the control groups in baseline data such as age, sex, body mass index, ACQ items, and ACQ scores. Total scores and all items of ACQ, with the exception of forced expiratory volume in one second (FEV1%), were significant between groups (P<0.05). No serious adverse effects were ob­served in the two groups. Conclusions: The results of this study reveal that compound honey syrup can be a safe and effective complementary drug for the treatment of pediatric asthma [GMJ.2017;6(4):291-301] DOI: 10.22086/gmj.v6i3.884

scholarly journals Characteristics and Specialist Linkage to Care of Patients Diagnosed With Chronic Hepatitis C Across Different Settings in an Urban Academic Hospital: Implications for Improving Diagnosis and Linkage to Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Dan C. S. Im ◽  
Susheel Reddy ◽  
Claudia Hawkins ◽  
Shannon Galvin
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Acute Care ◽  
Public Health Problem ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Chi Square ◽  
Race And Gender ◽  
Chronic Hcv

IntroductionChronic hepatitis C virus (HCV) infection is a significant public health problem. Strategies to identify more HCV infections and improve linkage to care (LTC) are needed. We compared characteristics, treatment and LTC among chronic HCV patients in different health care settings.MethodsNewly diagnosed HCV antibody positive (anti-HCV+) patients within settings of acute care, inpatient and outpatient in one health system were studied. Proportion of LTC and treatment were analyzed only for HCV RNA positive patients. Chi-square, one-way ANOVA and logistic regression were used to compare the characteristics and outcomes in the three care settings. Patients in acute care settings were excluded from multivariate analyses due to low sample size.ResultsAbout 43, 368, and 1159 anti-HCV+ individuals were identified in acute care, inpatient, and outpatient, respectively. Proportion of RNA positivity in acute, inpatient, and outpatient were 47.8, 60.3 and 29.2%, respectively (p &lt; 0.01). After adjusting for age, insurance type, race, and gender, outpatients had higher odds of LTC and of treatment (OR 4.7 [2.9, 7.6] and 4.5 [2.8, 7.3]).ConclusionsInpatients had lower proportion of LTC and treatment compared to outpatients. Use of LTC coordinators and the provision of integrated service for specialty care may improve outcomes.

scholarly journals Trends in Prevalence of Hepatitis B (HBV) and Hepatitis C (HCV) virus infection among blood donors in Apollo Hospital, Dhaka, Bangladesh, 2007-2011

Pulse ◽  
2014 ◽  
Vol 6 (1-2) ◽  
pp. 27-32 ◽  
Author(s):  
KM Huda ◽  
TA Nasir
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Public Health Problem ◽  
Hcv Infection ◽  
Infection Prevalence ◽  
Major Public Health Problem ◽  
Transmitted Infection ◽  
Recruitment And Selection

Transfusion transmitted infection (TTIs) is still a concern associated with blood transfusion as hepatitis B and hepatitis C remains a major public health problem in a country like Bangladesh. The trends of the prevalence of HBsAg and HCV infection among the healthy blood donors even in a tertiary level hospital could be a guide for planning and implementing programs for preventive measures. All samples of a total 18,381 unit of blood were screened for hepatitis B surface antigen and anti-hepatitis C virus antibodies at Apollo Hospitals Dhaka over a period of 5 years (2007-2011). The prevalence of HBV and HCV infection was calculated by year to demonstrate the trends. The overall sero prevalence rate of HBV and HCV among all blood donors at Apollo Hospitals, Dhaka during 2007 to 2011 was 1.42% and 0.10% respectively. There was decreasing trend observed in sero prevalence of HBV (1.77% vs 1.64%) and HCV (0.13% vs 0.02%) over five years of time, although this change was not statistically significant (p=0.16 for HBV and p=0.20 for HCV). However, a significant decreasing trend was observed in the sero prevalence of HBV among blood donors aged 30 years and above, which was 1.04% in 2011 against 1.73% in 2007 (p=0.04). The decreasing trend in the prevalence of HBV and HCV infection might be the result of improvement in donor recruitment and selection, replacement donation exclusion in transfusion services, and possibly decreasing HBV infection prevalence in general population. DOI: http://dx.doi.org/10.3329/pulse.v6i1-2.20330 Pulse Vol.6 January-December 2013 p.27-32

Hepatitis C virus resistance to interferon therapy: an alarming situation

2014 ◽  
Vol 9 (12) ◽  
pp. 1155-1167
Author(s):  
Sobia Kanwal ◽  
Tariq Mahmood
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Social Factors ◽  
Molecular Mechanisms ◽  
Public Health Problem ◽  
Pegylated Interferon ◽  
Host Factors ◽  
Interferon Α ◽  
Major Public Health Problem ◽  
Choice Of Treatment

AbstractHepatitis C virus is presently a major public health problem across the globe. The main objective in treating hepatitis C virus (HCV) infection is to achieve a sustained virological response (SVR). Interferon-α (IFN-α) and pegylated interferon (PegIFN) in combination with Ribavirin (RBV) are the choice of treatment nowadays against chronic hepatitis C. There are several mechanisms evolved by the hepatitis C virus that facilitate the persistence of virus and further lead the patient’s status as non responder. Various factors involved in patient’s lack ofresponse to the therapy include: (1) viral factors, (2) host factors, (3) molecular mechanisms related to the lack of response and (4) social factors. Herein we have made an attempt to summarize all the related predictors of drug resistance in one article so that the future polices can be planned to overcome this obstacle and potential therapies can be designed by considering these factors.

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