Hepatitis C cascade of care among people who inject drugs in Vancouver, Canada.

Abstract:

BACKGROUND:People who inject drugs (PWID) have high rates of hepatitis C virus (HCV) infection. Little is known about the rates of diagnosis and treatment for HCV among PWID. Therefore, this study aims to characterize the cascade of care in Vancouver, Canada, to improve HCV treatment access and delivery for PWID. METHODS:Data were derived from 3 prospective cohort studies of PWID in Vancouver, Canada, between December 2005 and May 2015. The progression of participants was identified through 5 steps in the cascade of care: (1) chronic HCV; (2) linkage to HCV care; (3) liver disease assessment; (4) initiation of treatment; and (5) completion of treatment. Predictors of undergoing liver disease assessment for HCV treatment were identified using a multivariable extended Cox regression model. RESULTS:Among 1571 participants with chronic HCV, 1359 (86.5%) had ever been linked to care, 1257 (80.0%) had undergone liver disease assessment, 163 (10.4%) had ever started HCV treatment, and 71 (4.5%) had ever completed treatment. In multivariable analyses, human immunodeficiency virus (HIV) seropositivity, use of methadone maintenance therapy, and hospitalization in the past 6 months were independently and positively associated with undergoing liver disease assessment (all P < .001), whereas daily heroin injection was independently and negatively associated with undergoing liver disease assessment (P < .001). CONCLUSIONS:Among this cohort of PWID, few had been started on or completed treatment for HCV. These findings highlight the need to improve the prescribing of HCV treatment among PWID with active substance use.

journal_name

Subst Abus

journal_title

Substance abuse

authors

Young S,Wood E,Milloy MJ,DeBeck K,Dobrer S,Nosova E,Kerr T,Hayashi PhD K

doi

10.1080/08897077.2018.1485128

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

461-468

issue

4

eissn

0889-7077

issn

1547-0164

journal_volume

39

pub_type

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