Utility of a one-step screening and diagnosis strategy for viremic HCV infection among people who inject drugs in Catalonia

Saludes, Verónica; Antuori, Adrián; Folch, Cinta; González, Noemí; Ibáñez, Núria; Majó, Xavier; Colom, Joan; Matas, Lurdes; Casabona, Jordi; Martró, Elisa

doi:10.1016/j.drugpo.2019.10.012

Cited by 31 publications

(44 citation statements)

References 43 publications

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“…Although the percentage is not extremely high, this is a modifiable factor that can be improved. Point-of-care HCV RNA testing by non-invasive dried blood spot analysis has shown high sensitivity and specificity 10 , 25 and could be a feasible way to increase screening rates in the SUD population.…”

Section: Discussionmentioning

confidence: 99%

“…9 A study in people who inject drugs in Catalonia (Spain) showed an overall HCV seroprevalence of 79.8%, and viremic infection in 58.5%. 10 However, there is little updated information for individuals using non-injected drugs. A study conducted in 2001 reported that the prevalence of anti-HCV antibodies in a sample of 529 non-injecting drug users (heroin, cocaine, or crack) ranged from 5% to 29%.…”

Section: Introductionmentioning

confidence: 99%

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Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management

Grau-López

Marcos‐Fosch

Daigre

et al. 2021

Therap Adv Gastroenterol

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Background: Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis). Methods: This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients’ consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed. Results: 528 individuals attended the center (November 2018–June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence versus patients with SUD alone ( p = 0.28). Dual diagnosis did not lead to a higher risk of HCV infection or interfere with linkage to care or treatment. Conclusion: This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management

Grau-López

Marcos‐Fosch

Daigre

et al. 2021

Therap Adv Gastroenterol

Self Cite

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“…HCV diagnostic interpretations by such innovative tools can also be useful to assess the performance of targeted harm reduction programs as well as to design test-and-treat strategies and to facilitating linkage to care in this key population [ 106 ]. Another study predicted the HCV-RNA testing was more feasible than DBS and showed 97.2% sensitivity and 100% specificity for viral loads >3000 IU/mL in PWIDs in real-world settings [ 107 ]. A performance in concordance with no significant difference was observed when detecting viremic infections between this one-step DBS testing strategy vs. the traditional two-step diagnostic algorithm involving venous blood samples.…”

Section: The Real-world Clinical Performance Of Current Hcv Diagnostic Algorithmsmentioning

confidence: 99%

Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

et al. 2021

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The simplification of current hepatitis C diagnostic algorithms and the emergence of digital diagnostic devices will be very crucial to achieving the WHO’s set goals of hepatitis C diagnosis (i.e., 90%) by 2030. From the last decade, hepatitis C diagnosis has been revolutionized by the advent and approval of state-of-the-art HCV diagnostic platforms which have been efficiently implemented in high-risk HCV populations in developed nations as well as in some low-to-middle income countries (LMICs) to identify millions of undiagnosed hepatitis C-infected individuals. Point-of-care (POC) rapid diagnostic tests (RDTs; POC-RDTs), RNA reflex testing, hepatitis C self-test assays, and dried blood spot (DBS) sample analysis have been proven their diagnostic worth in real-world clinical experiences both at centralized and decentralized diagnostic settings, in mass hepatitis C screening campaigns, and hard-to-reach aboriginal hepatitis C populations in remote areas. The present review article overviews the significance of current and emerging hepatitis C diagnostic packages to subvert the public health care burden of this ‘silent epidemic’ worldwide. We also highlight the challenges that remain to be met about the affordability, accessibility, and health system-related barriers to overcome while modulating the hepatitis C care cascade to adopt a ‘test and treat’ strategy for every hepatitis C-affected individual. We also elaborate some key measures and strategies in terms of policy and progress to be part of hepatitis C care plans to effectively link diagnosis to care cascade for rapid treatment uptake and, consequently, hepatitis C cure.

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“…La prevalencia de infección activa de VHC en las 410 personas usuarias de drogas fue del 58,5%, y un 35,8% de ellas no conocía su estado previamente. La sensibilidad y especificidad de la detección directa del ARN en sangre seca fue similar al diagnóstico en dos pasos (prueba rápida de anticuerpos seguida del estudio del ARN en plasma), concluyendo que puede mejorar las tasas de diagnóstico de infección activa en las personas que se inyectan drogas (91).…”

Section: C) Diagnóstico Completo E Inicio Del Tratamiento En El Mismo Día  Centro De Atención Y Seguimiento De Drogodependencias De Nou unclassified

Guía de cribado de la infección por el VHC en España, 2020

Escanilla¹

2020

Med Gen Fam

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Utility of a one-step screening and diagnosis strategy for viremic HCV infection among people who inject drugs in Catalonia

Cited by 31 publications

References 43 publications

Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management

Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management

Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

Guía de cribado de la infección por el VHC en España, 2020

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