Buprenorphine for Human Immunodeficiency Virus/Hepatitis C Virus–coinfected Patients

Taylor, Lynn E.; Maynard, Michaela; Friedmann, Peter D.; MacLeod, Cynthia; Rich, Josiah D.; Flanigan, Timothy P.; Sylvestre, Diana L.

doi:10.1097/adm.0b013e318257377f

Cited by 11 publications

(10 citation statements)

References 43 publications

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“…In this study of patients receiving buprenorphine treatment for opioid use disorders, 53% were infected with HCV, and 34% were confirmed to have chronic HCV infection. Our findings are similar to others’ findings in which HCV infection among patients receiving opioid agonist treatment has ranged from 30–90%(Hallinan, Byrne, Amin, & Dore, 2005; Murphy, Dweik, McPherson, & Roll, 2015; Taylor et al, 2012). Currently, heroin use is on the rise in the US, with unprecedented increases in almost every demographic group over the last decade(Jones et al, 2015).…”

Section: Discussionsupporting

confidence: 92%

Retention in buprenorphine treatment is associated with improved HCV care outcomes

Norton

Beitin

Glenn

et al. 2017

Journal of Substance Abuse Treatment

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Persons who inject drugs, most of whom are opioid dependent, comprise the majority of the HCV infected in the United States. As the national opioid epidemic unfolds, increasing numbers of people are entering the medical system to access treatment for opioid use disorder, specifically with buprenorphine. Yet little is known about HCV care in patients accessing buprenorphine-based opioid treatment. We sought to determine the HCV prevalence, cascade of care, and the association between patient characteristics and completion of HCV cascade of care milestones for patients initiating buprenorphine treatment. We reviewed electronic health records of all patients who initiated buprenorphine treatment at a primary-care clinic in the Bronx, NY between January 2009-January 2014. Of the 390 patients who initiated buprenorphine treatment, 123 were confirmed to have chronic HCV infection. The only patient characteristic associated with achieving HCV care milestones was retention in opioid treatment. Patients retained (vs. not retained) in buprenorphine treatment were more likely to be referred for HCV specialty care (63.1% vs. 34.0%, p<0.01), achieve an HCV-specific evaluation (40.8% vs. 21.3%, p<0.05), be offered HCV treatment (22.4% vs. 8.5%, p<0.05), and initiate HCV treatment (9.2% vs. 6.4%, p=0.6). Given the current opioid epidemic in the US and the growing number of people receiving buprenorphine treatment, there is an unprecedented opportunity to access and treat persons with HCV, reducing HCV transmission, morbidity and mortality. Retention in opioid treatment may improve linkage and retention in HCV care; innovative models of care that integrate opioid drug treatment with HCV treatment are essential.

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Section: Discussionsupporting

confidence: 92%

Retention in buprenorphine treatment is associated with improved HCV care outcomes

Norton

Beitin

Glenn

et al. 2017

Journal of Substance Abuse Treatment

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“…A hospital-based HIV clinic in Providence, Rhode Island. The clinic cares for 1400 HIV-infected patients, of whom approximately 30% have OUD [ 41 •].…”

Section: Resultsmentioning

confidence: 99%

Integrated Models of Care for Individuals with Opioid Use Disorder: How Do We Prevent HIV and HCV?

et al. 2018

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Purpose of ReviewTo describe models of integrated and co-located care for opioid use disorder (OUD), hepatitis C (HCV), and HIV.Recent FindingsThe design and scale-up of multidisciplinary care models that engage, retain, and treat individuals with HIV, HCV, and OUD are critical to preventing continued spread of HIV and HCV. We identified 17 models within primary care (N = 3), HIV specialty care (N = 5), opioid treatment programs (N = 6), transitional clinics (N = 2), and community-based harm reduction programs (N = 1), as well as two emerging models.SummaryKey components of such models are the provision of (1) medication-assisted treatment for OUD, (2) HIV and HCV treatment, (3) HIV pre-exposure prophylaxis, and (4) behavioral health services. Research is needed to understand differences in effectiveness between co-located and fully integrated care, combat the deleterious racial and ethnic legacies of the “War on Drugs,” and inform the delivery of psychiatric care. Increased access to harm reduction services is crucial.Electronic supplementary materialThe online version of this article (10.1007/s11904-018-0396-x) contains supplementary material, which is available to authorized users.

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“…Integrations occurred at all system levels, but most (n =30) described micro level service integration [33][34][35][36][37][38][39][40][41]44,[47][48][49][51][52][53][57][58][59][61][62][63][66][67][68][69][70][71]76,77,79,80,82] ( Table 2). Within HIV facilities, 15 studies explored micro level integration [33][34][35][36][37]48,49,52,[61][62][63]67,[69][70][71], one described meso level clinical integration [60] and five described macro level integration…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Integrating HIV and substance use services: a systematic review

Haldane

Cervero-Liceras

Chuah

et al. 2017

Journal of the International AIDS Society

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Introduction: Substance use is an important risk factor for HIV, with both concentrated in certain vulnerable and marginalized populations. Although their management differs, there may be opportunities to integrate services for substance use and HIV. In this paper we systematically review evidence from studies that sought to integrate care for people living with HIV and substance use problems.Methods: Studies were included if they evaluated service integration for substance use and HIV. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias.Results and discussion: 11,057 records were identified, with 7616 after removal of duplicates. After screening titles and abstracts, 51 met the inclusion criteria. Integration models were categorized by location (HIV, substance use and other facilities), level of integration from mirco (integrated care delivered to individuals) to macro (system level integrations) and degree of integration from least (screening and counselling only) to most (care for HIV, substance use and/or other illnesses at the same facility). Most reported descriptive or cohort studies; in four randomized control trials integrated activities improved patient outcomes. There is potential for integrating services at all facility types, including mobile health services. While services offering screening only can achieve synergies, there are benefits from delivering integrated treatment for HIV and substance use, including ease of referral to other mental health and social services.Conclusions: Our review used a wide range of databases and conference archives to increase representation of papers from low- and middle-income countries. Limitations include the overrepresentation of studies from the United States, and the descriptive nature of the majority of papers. The evidence reviewed shows that greater integration offers important benefits in both patient and service outcomes but further research and outcome reporting is needed to better understand innovative and holistic care models at the complex intersection of substance use and HIV services.

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Buprenorphine for Human Immunodeficiency Virus/Hepatitis C Virus–coinfected Patients

Cited by 11 publications

References 43 publications

Retention in buprenorphine treatment is associated with improved HCV care outcomes

Retention in buprenorphine treatment is associated with improved HCV care outcomes

Integrated Models of Care for Individuals with Opioid Use Disorder: How Do We Prevent HIV and HCV?

Integrating HIV and substance use services: a systematic review

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