An intervention to improve HCV testing, linkage to care, and treatment among people who use drugs in Tehran, Iran: The ENHANCE study

被引:27
|
作者
Alavi, Maryam [1 ,2 ]
Poustchi, Hossein [2 ]
Merat, Shahin [2 ]
Kaveh-ei, Soudeh [2 ]
Rahimi-Movaghar, Afarin [3 ]
Shadloo, Behrang [3 ]
Hajarizadeh, Behzad [1 ]
Grebely, Jason [1 ]
Dore, Gregory J. [1 ]
Malekzadeh, Reza [2 ]
机构
[1] UNSW Sydney, Kirby Inst, Viral Hepatitis Clin Res Program, Wallace Wurth Bldg, Sydney, NSW 2052, Australia
[2] Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran
[3] Univ Tehran Med Sci, Iranian Natl Ctr Addict Studies, Tehran, Iran
基金
英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;
关键词
Hepatitis C; People who inject drugs; Middle-income countries; DAA uptake; Integrated model of care; HEPATITIS-C VIRUS; HARM REDUCTION PROGRAMS; INJECT DRUGS; HEALTH; PREVALENCE; FIBROSIS;
D O I
10.1016/j.drugpo.2019.07.002
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: Globally, HCV testing, linkage to care and treatment is sub-optimal among people who use drugs (PWUD). This study aimed to evaluate the impact of an innovative intervention to enhance HCV testing, linkage to care, and treatment initiation among PWUD in Tehran, Iran. Methods: ENHANCE is a non-randomized trial evaluating the effect of on-site rapid HCV antibody testing, venepuncture for HCV RNA testing (HCV antibody positive only), liver fibrosis assessment, and linkage to care to enhance direct-acting antiviral (DAA) therapy (sofosbuvir/daclatasvir) initiation for HCV among people with a history of drug use. Recruitment was from April 2018 and will continue to July 2019, through three opioid substitution treatment (OST) clinics, five community-based drop-in centres, and one homeless reception centre. Participants initiated DAA therapy at a specialist clinic (OST clinics) or on-site (other sites), with monitoring provided on-site or at the specialist clinic (for those with cirrhosis attending OST clinics). Results: Among 632 participants enrolled (median age, 44 years), 97% were male, 28% had a history of injecting drug use, and 58% had used drugs within the previous year. HCV antibody prevalence was 27%; 62% and 15% among those with and without a history of injecting drug use. Among 170 HCV antibody positive participants, 168 had HCV RNA testing (99%), of whom 134 (80%) were positive. Among HCV RNA positive participants, treatment initiation was 84%: 100% (45/45), 96% (46/48) and 54% (22/41) in OST clinics, drop-in centres, and homeless reception settings, respectively. Conclusion: Following on-site HCV testing and linkage to care, HCV treatment uptake was extremely high among PWUD, apart from the homeless reception population. This intervention could be explored in other settings globally to enhance HCV scale-up and elimination efforts.
引用
收藏
页码:99 / 105
页数:7
相关论文
共 50 条
  • [2] Barriers of linkage to HCV viremia testing among people who inject drugs in Georgia
    Maia Butsashvili
    Tinatin Abzianidze
    George Kamkamidze
    Lasha Gulbiani
    Lia Gvinjilia
    Tinatin Kuchuloria
    Irina Tskhomelidze
    Maka Gogia
    Maia Tsereteli
    Veronique Miollany
    Tamar Kikvidze
    Shaun Shadaker
    Muazzam Nasrullah
    Francisco Averhoff
    [J]. Substance Abuse Treatment, Prevention, and Policy, 17
  • [3] Barriers of linkage to HCV viremia testing among people who inject drugs in Georgia
    Butsashvili, Maia
    Abzianidze, Tinatin
    Kamkamidze, George
    Gulbiani, Lasha
    Gvinjilia, Lia
    Kuchuloria, Tinatin
    Tskhomelidze, Irina
    Gogia, Maka
    Tsereteli, Maia
    Miollany, Veronique
    Kikvidze, Tamar
    Shadaker, Shaun
    Nasrullah, Muazzam
    Averhoff, Francisco
    [J]. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY, 2022, 17 (01)
  • [4] A Testing Campaign Intervention Consisting of Peer-Facilitated Engagement, Point-of-Care HCV RNA Testing, and Linkage to Nursing Support to Enhance Hepatitis C Treatment Uptake among People Who Inject Drugs: The ETHOS Engage Study
    Conway, Anna
    Valerio, Heather
    Alavi, Maryam
    Silk, David
    Treloar, Carla
    Hajarizadeh, Behzad
    Marshall, Alison D.
    Martinello, Marianne
    Milat, Andrew
    Dunlop, Adrian
    Murray, Carolyn
    Prain, Bianca
    Henderson, Charles
    Amin, Janaki
    Read, Phillip
    Marks, Pip
    Degenhardt, Louisa
    Hayllar, Jeremy
    Reid, David
    Gorton, Carla
    Lam, Thao
    Christmass, Michael
    Wade, Alexandra
    Montebello, Mark
    Dore, Gregory J.
    Grebely, Jason
    [J]. VIRUSES-BASEL, 2022, 14 (07):
  • [5] HCV screening based on dried blood samples and linkage to care in people who use drugs: A prospective study
    Ryan, Pablo
    Valencia, Jorge
    Cuevas, Guillermo
    Troya, Jesus
    Ramon, Cristina
    Rodriguez, Antonio
    Torres-Macho, Juan
    Munoz-Gomez, Maria Jose
    Canorea, Isabel
    Vazquez-Moron, Sonia
    Resino, Salvador
    [J]. INTERNATIONAL JOURNAL OF DRUG POLICY, 2021, 92
  • [6] Interventions to enhance testing, linkage to care and treatment uptake for hepatitis C virus infection among people who inject drugs: A systematic review
    Bajis, Sahar
    Dore, Gregory J.
    Hajarizadeh, Behzad
    Cunningham, Evan B.
    Maher, Lisa
    Grebely, Jason
    [J]. INTERNATIONAL JOURNAL OF DRUG POLICY, 2017, 47 : 34 - 46
  • [7] Non -fatal overdose among people who inject drugs in Tehran, Iran
    Mehdi Noroozi
    Peter Higgs
    Azadeh Bayani
    Bahram Armoon
    Ali Nazeri Astaneh
    Ladan Fattah Moghaddam
    Mohammad Askari
    [J]. Substance Abuse Treatment, Prevention, and Policy, 15
  • [8] Non -fatal overdose among people who inject drugs in Tehran, Iran
    Noroozi, Mehdi
    Higgs, Peter
    Bayani, Azadeh
    Armoon, Bahram
    Astaneh, Ali Nazeri
    Moghaddam, Ladan Fattah
    Askari, Mohammad
    [J]. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY, 2020, 15 (01)
  • [9] People who inject drugs: testing and treatment of HIV and HCV
    Sarker, Md Safiullah
    [J]. LANCET GLOBAL HEALTH, 2023, 11 (12): : E1832 - E1833
  • [10] Uptake of testing, linkage to care, and treatment for hepatitis C infection among people who inject drugs in Australia: The ETHOS Engage study
    Valerio, Heather
    Alavi, Maryam
    Silk, David
    Treloar, Carla
    Milat, Andrew
    Dunlop, Adrian
    Holden, Jo
    Henderson, Charles
    Amin, Janaki
    Read, Phillip
    Degenhardt, Louisa
    Dore, Gregory
    Grebely, Jason
    [J]. JOURNAL OF HEPATOLOGY, 2019, 70 (01) : E42 - E42