Challenges and Opportunities for Treating Hepatitis C Amongst People Who Use Drugs: Experience of an Integrated Mobile Clinic in Baltimore City.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Amanda Rosecrans, Robert Harris, Anne St Clair, Molly Rice, Meredith Zoltick, Catherine Willman, Anne King, Meredith Kerr, Kathleen R Page
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引用次数: 0

Abstract

Progress in treating chronic hepatitis C virus (HCV) infection has been slow amongst people who use drugs (PWUD). This study describes the HCV treatment cascade amongst people accessing a mobile clinic offering integrated low-threshold buprenorphine and infectious disease services in Baltimore City. From May 1, 2021, to December 31, 2022, 560 people had a rapid HCV antibody test, of whom 201 (36%) had a positive result and amongst those, 117 (58%) had an HCV RNA test performed, 81 (40%) had a documented positive RNA, 45 (22%) were prescribed medication, 42 (21%) started medication, 32 (16%) completed medication, 22 (11%) had blood work to assess for sustained virologic response and 20 (10%) had a documented cure. Challenges including housing instability, insurance barriers and lack of venous access limit progress in this cascade. Providing integrated care models to meet the needs of PWUD in the community is necessary but not sufficient to make progress in improving HCV treatment. Removal of insurance restrictions, availability of point-of-care HCV RNA testing, development of rapid HCV treatment guidelines and development of long-acting injectable HCV treatment are needed to move towards a same-day, one-time test and treat model of care.

治疗吸毒者丙型肝炎的挑战与机遇:巴尔的摩市综合流动诊所的经验。
在吸毒者(PWUD)中,慢性丙型肝炎病毒(HCV)感染的治疗进展缓慢。本研究描述了巴尔的摩市一家提供低门槛丁丙诺啡和传染病综合服务的流动诊所对丙型肝炎病毒感染者的治疗过程。从 2021 年 5 月 1 日到 2022 年 12 月 31 日,共有 560 人接受了丙型肝炎病毒抗体快速检测,其中 201 人(36%)检测结果呈阳性,在这些人中,117 人(58%)接受了丙型肝炎病毒 RNA 检测,81 人(40%)的 RNA 呈阳性,45 人(22%)获得处方药物治疗,42 人(21%)开始接受药物治疗,32 人(16%)完成药物治疗,22 人(11%)进行了血液检查以评估持续病毒学应答,20 人(10%)获得有记录的治愈。包括住房不稳定、保险障碍和缺乏静脉通道在内的挑战限制了这一流程的进展。提供综合护理模式以满足社区中艾滋病毒感染者和艾滋病患者的需求是必要的,但还不足以在改善 HCV 治疗方面取得进展。需要取消保险限制、提供护理点 HCV RNA 检测、制定快速 HCV 治疗指南和开发长效注射 HCV 治疗方法,以实现当天、一次性检测和治疗的护理模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Viral Hepatitis
Journal of Viral Hepatitis 医学-病毒学
CiteScore
6.00
自引率
8.00%
发文量
138
审稿时长
1.5 months
期刊介绍: The Journal of Viral Hepatitis publishes reviews, original work (full papers) and short, rapid communications in the area of viral hepatitis. It solicits these articles from epidemiologists, clinicians, pathologists, virologists and specialists in transfusion medicine working in the field, thereby bringing together in a single journal the important issues in this expanding speciality. The Journal of Viral Hepatitis is a monthly journal, publishing reviews, original work (full papers) and short rapid communications in the area of viral hepatitis. It brings together in a single journal important issues in this rapidly expanding speciality including articles from: virologists; epidemiologists; clinicians; pathologists; specialists in transfusion medicine.
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