Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya

Akiyama, Matthew J.; Riback, Lindsey; Nyakowa, Mercy; Musyoki, Helgar; Lizcano, John; Muller, Abbe; Zhang, Chenshu; Walker, Josephine G.; Stone, Jack; Vickerman, Peter; Cherutich, Peter; Kurth, Ann

doi:10.1016/j.drugpo.2023.103959

Cited by 5 publications

(1 citation statement)

References 54 publications

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“…Peer‐supported engagement/delivery has also led to high HCV treatment uptake (majority single‐visit) among people with recent injecting drug use 43 . In Kenya, HCV treatment with Directly Observed Therapy (DOT) with peer support was an effective approach among PWID 44 . A randomised controlled trial (RCT) based in outreach services for those experiencing problematic drug use or homelessness in the UK, showed providing a peer advocate increased the likelihood of successful engagement with healthcare by 18% 45 and the odds of a successful outcome were 2.5 times higher than in the group without a peer advocate.…”

Section: Evidence Supporting the Success Of Peer Support Programmesmentioning

confidence: 99%

Peer support for people living with hepatitis B virus—A foundation for treatment expansion

Downs,

Kabagambe,

Williams

et al. 2024

Journal of Viral Hepatitis

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Chronic hepatitis B infection (CHB) affects 300 million people worldwide and is being targeted by the United Nations 2030 Sustainable Development Goals (SDGs) and the World Health Organisation (WHO), working towards elimination of hepatitis B virus (HBV) as a public health threat. In this piece, we explore the evidence and potential impact of peer support to enhance and promote interventions for people living with CHB. Peer support workers (PSWs) are those with lived experience of an infection, condition or situation who work to provide support for others, aiming to improve education, prevention, treatment and other clinical interventions and to reduce the physical, psychological and social impacts of disease. Peer support has been shown to be a valuable tool for improving health outcomes for people living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), but to date has not been widely available for communities affected by HBV. HBV disproportionately affects vulnerable and marginalised populations, who could benefit from PSWs to help them navigate complicated systems and provide advocacy, tackle stigma, improve education and representation, and optimise access to treatment and continuity of care. The scale up of peer support must provide structured and supportive career pathways for PSWs, account for social and cultural needs of different communities, adapt to differing healthcare systems and provide flexibility in approaches to care. Investment in peer support for people living with CHB could increase diagnosis, improve retention in care, and support design and roll out of interventions that can contribute to global elimination goals.

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Section: Evidence Supporting the Success Of Peer Support Programmesmentioning

confidence: 99%

Peer support for people living with hepatitis B virus—A foundation for treatment expansion

Downs,

Kabagambe,

Williams

et al. 2024

Journal of Viral Hepatitis

View full text Add to dashboard Cite

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Ledipasvir/sofosbuvir

2023

Reactions Weekly

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Peer-Assisted Telemedicine for Hepatitis C in People Who Use Drugs: A Randomized Controlled Trial

Seaman,

Cook,

Leichtling

et al. 2024

Clinical Infectious Diseases

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Background Hepatitis C virus (HCV) elimination requires treating people who use drugs (PWUD), yet fewer than 10% of PWUD in the United States access HCV treatment and access is especially limited in rural communities. Methods We randomized PWUD with HCV viremia and past 90-day injection drug or non-prescribed opioid use in seven rural Oregon counties to peer-assisted telemedicine HCV treatment (TeleHCV) versus peer-assisted referral to local providers (enhanced usual care; EUC). Peers supported screening and pre-treatment laboratory evaluation for all participants and facilitated telemedicine visits, medication delivery, and adherence for TeleHCV participants. Generalized linear models estimated group differences in HCV viral clearance (primary outcome) and HCV treatment initiation and completion (secondary outcomes). Results Of the 203 randomized participants (100 TeleHCV, 103 EUC), most were male (62%), white (88%), with recent houselessness (70%), and used methamphetamines (88%) or fentanyl/heroin (58%) in the past 30 days. Eighty-five of 100 TeleHCV participants (85%) initiated treatment versus 13 of 103 (12%) EUC participants (RR = 6.7, 95% CI 4.0 to 11.3, p<0.001). Sixty-three of 100 (63%) TeleHCV participants vs. 16 of 103 (16%) EUC participants achieved viral clearance 12 weeks after anticipated treatment completion date (RR = 4.1, 95% CI 2.5 to 6.5, p <0.001). Conclusions The Peer TeleHCV treatment model substantially increased HCV treatment initiation and viral clearance compared to EUC. Replication in other rural and low-resource settings could further World Health Organization HCV elimination goals by expanding and decentralizing treatment access for PWUD. Clinical Trials Registry NCT04798521

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Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya

Cited by 5 publications

References 54 publications

Peer support for people living with hepatitis B virus—A foundation for treatment expansion

Peer support for people living with hepatitis B virus—A foundation for treatment expansion

Ledipasvir/sofosbuvir

Peer-Assisted Telemedicine for Hepatitis C in People Who Use Drugs: A Randomized Controlled Trial

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