Access to care of patients with chronic hepatitis C virus infection in a university hospital: Is opioid dependence a limiting condition?

Perut, V.; Labalette, Céline; Sogni, Philippe; Ferrand, I.; Salmon‐Céron, Dominique; Vidal-Trécan, G.

doi:10.1016/j.drugalcdep.2009.04.002

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…An increasing proportion is seen by setting and study type with progressively selected study populations, with a median of 23% (IQR 17–31) in nine intervention non-clinical studies, 28% (IQR 24–42) in seven observational clinical studies [22], [103], [115], [131], [198], [200], [204] and 47% in one intervention clinical study [126]. Four studies with non-clinical recruitment settings provided a proportion of antibody positive PWID self-reporting having ever been treated, with a median of 4.7% (3.4–37, IQR 4.3–13, n = 868) [79], [146], [165], [202].…”

Section: Resultsmentioning

confidence: 99%

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

et al. 2014

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BackgroundPeople who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. The availability in the literature of information on seven main topic areas (incidence, chronicity, genotypes, HIV co-infection, diagnosis and treatment uptake, and burden of disease) to guide HCV treatment and prevention scale-up for PWID in the 27 countries of the European Union is systematically reviewed.Methods and FindingsWe searched MEDLINE, EMBASE and Cochrane Library for publications between 1 January 2000 and 31 December 2012, with a search strategy of general keywords regarding viral hepatitis, substance abuse and geographic scope, as well as topic-specific keywords. Additional articles were found through structured email consultations with a large European expert network. Data availability was highly variable and important limitations existed in comparability and representativeness. Nine of 27 countries had data on HCV incidence among PWID, which was often high (2.7-66/100 person-years, median 13, Interquartile range (IQR) 8.7–28). Most common HCV genotypes were G1 and G3; however, G4 may be increasing, while the proportion of traditionally ‘difficult to treat’ genotypes (G1+G4) showed large variation (median 53, IQR 43–62). Twelve countries reported on HCV chronicity (median 72, IQR 64–81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%, IQR 0.2–28). Undiagnosed infection, assessed in five countries, was high (median 49%, IQR 38–64), while of those diagnosed, the proportion entering treatment was low (median 9.5%, IQR 3.5–15). Burden of disease, where assessed, was high and will rise in the next decade.ConclusionKey data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID.

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Section: Resultsmentioning

confidence: 99%

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

et al. 2014

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“…Median (IQR) follow-up study duration was 16 (12-23) months, not including patients who had only one visit. The median (IQR) time between two study visits was 11 (8)(9)(10)(11)(12)(13) months. Considering only those visits where patients were receiving HCV therapy, we found the following distribution: 32 patients had one visit, 24 had two visits and 13 had three visits, while only one patient had four visits during treatment.…”

Section: Discussionmentioning

confidence: 99%

“…According to the study by Backus et al, carried out in 2006, the control of HIV disease is one of the most important modifiable factors affecting access to HCV therapy [8]. Despite it being a short-course therapy, many physicians still remain reluctant to initiate HCV treatment under the pretext that coinfected patients' life-styles are generally chaotic and that having many concurrent medical conditions [9] could limit adherence [10] and sustained virological response (SVR) [11][12][13]. Moreover, the risk of HCV re-infection after treatment, the burden of additional side effects, including depressive symptoms [14] and their possible management [15], together with drug-drug interactions, may all be additional reasons why physicians delay HCV treatment.…”

Section: Introductionmentioning

confidence: 99%

Positive impact of hepatitis C virus (HCV) treatment on antiretroviral treatment adherence in human immunodeficiency virus–HCV coinfected patients: one more argument for expanded access to HCV treatment for injecting drug users

et al. 2011

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“…It has been shown for example that isolation, lack of social support and legal issues are related to HCV treatment initiation [33] and that drug use and opioid dependence are conditions limiting not only access to liver biopsy [34,35] but also referral for [36,37] and initiation of HCV treatment [38]. It has also been consistently shown that opioid maintenance treatment facilitates HCV treatment initiation [39], especially in the case of one-site models of care.…”

Section: Introductionmentioning

confidence: 99%

Engaging HIV-HCV co-infected patients in HCV treatment: the roles played by the prescribing physician and patients' beliefs (ANRS CO13 HEPAVIH cohort, France)

Salmon‐Céron

Cohen

Winnock

et al. 2012

BMC Health Serv Res

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Background Treatment for the hepatitis C virus (HCV) may be delayed significantly in HIV/HCV co-infected patients. Our study aims at identifying the correlates of access to HCV treatment in this population. Methods We used 3-year follow-up data from the HEPAVIH ANRS-CO13 nationwide French cohort which enrolled patients living with HIV and HCV. We included pegylated interferon and ribavirin-naive patients (N = 600) at enrolment. Clinical/biological data were retrieved from medical records. Self-administered questionnaires were used for both physicians and their patients to collect data about experience and behaviors, respectively. Results Median [IQR] follow-up was 12[12-24] months and 124 patients (20.7%) had started HCV treatment. After multiple adjustment including patients' negative beliefs about HCV treatment, those followed up by a general practitioner working in a hospital setting were more likely to receive HCV treatment (OR[95%CI]: 1.71 [1.06-2.75]). Patients followed by general practitioners also reported significantly higher levels of alcohol use, severe depressive symptoms and poor social conditions than those followed up by other physicians. Conclusions Hospital-general practitioner networks can play a crucial role in engaging patients who are the most vulnerable and in reducing existing inequities in access to HCV care. Further operational research is needed to assess to what extent these models can be implemented in other settings and for patients who bear the burden of multiple co-morbidities.

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Access to care of patients with chronic hepatitis C virus infection in a university hospital: Is opioid dependence a limiting condition?

Cited by 7 publications

References 25 publications

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

Positive impact of hepatitis C virus (HCV) treatment on antiretroviral treatment adherence in human immunodeficiency virus–HCV coinfected patients: one more argument for expanded access to HCV treatment for injecting drug users

Engaging HIV-HCV co-infected patients in HCV treatment: the roles played by the prescribing physician and patients' beliefs (ANRS CO13 HEPAVIH cohort, France)

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