Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu, Nepal

Hepatitis C care continuum and associated barriers among people who inject drugs in Chennai, India

“…The literature on HCV treatment barriers among PWID in LMIC is sparse and even fewer studies have been conducted in the DAA era. Our findings are comparable to other data from the region including studies from Nepal, Malaysia, Iran and China (Alam-Mehrjerdi et al, 2016; Chu et al, 2016; Loewinger et al, 2016; Mukherjee et al, 2017), all of which demonstrate that a key barrier to engaging in HCV care and/or treatment is limited knowledge of HCV among PWID, including those accessing opioid and needle exchange services. Of these clinic-based studies, only one includes data from the DAA era (Mukherjee et al, 2017).…”

“…In high-income countries, the high attrition from HCV diagnosis to initiation of HCV treatment among PWID can be explained by a multifactorial network of individual-, provider-, and system- and structural-level barriers (Alavi et al, 2015; Doab, Treloar, & Dore, 2005; Fischer, Vasdev, Haydon, Baliunas, & Rehm, 2005; Grebely et al, 2011; Grebely et al, 2008; Heimer et al, 2002; Kwiatkowski, Fortuin Corsi, & Booth, 2002; Mehta et al, 2008; Mehta et al, 2005; Scheft & Fontenette, 2005; Sulkowski & Thomas, 2005; Treloar et al, 2011; Treloar, Hull, Dore, & Grebely, 2012; Wansom et al, 2017), some of which have not changed despite the availability of DAAs (Asher et al, 2016; Cope, Glowa, Faulds, McMahon, & Prasad, 2016; Falade-Nwulia et al, 2016; Mah et al, 2017; Socias et al, 2017; Valerio, et al, 2018). There is a paucity of data on HCV treatment uptake and associated barriers among PWID in low-and-middle income countries (LMIC) (Alam-Mehrjerdi et al, 2016; Chu et al, 2016; Loewinger et al, 2016; Mukherjee et al, 2017; Souliotis, Agapidaki, Papageorgiou, Voudouri, & Contiades, 2017), particularly from Southern and South-eastern Asia (Wait et al, 2016). Preliminary evidence from this region suggests there is poor knowledge of HCV disease and treatment among PWID attending methadone clinics, needle-exchange programs, and rehabilitation centers (Chu et al, 2016; Loewinger et al, 2016; Mukherjee et al, 2017), which may be indicative of structural barriers related to treatment availability and cost, as well as of low patient readiness for HCV treatment (i.e., low awareness and perceived need for treatment).…”

“…There is a paucity of data on HCV treatment uptake and associated barriers among PWID in low-and-middle income countries (LMIC) (Alam-Mehrjerdi et al, 2016; Chu et al, 2016; Loewinger et al, 2016; Mukherjee et al, 2017; Souliotis, Agapidaki, Papageorgiou, Voudouri, & Contiades, 2017), particularly from Southern and South-eastern Asia (Wait et al, 2016). Preliminary evidence from this region suggests there is poor knowledge of HCV disease and treatment among PWID attending methadone clinics, needle-exchange programs, and rehabilitation centers (Chu et al, 2016; Loewinger et al, 2016; Mukherjee et al, 2017), which may be indicative of structural barriers related to treatment availability and cost, as well as of low patient readiness for HCV treatment (i.e., low awareness and perceived need for treatment). Individual-level indicators of HCV treatment readiness, such as treatment willingness and intentions, have not been fully examined among PWID in LMIC.…”