Peer-delivered mail-order self-collection and linkage to treatment for hepatitis C virus infection among users of a harm reduction service in Denmark

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-07-18 DOI:10.1016/j.drugpo.2025.104919

Jonas Demant , Stephen Strunge Nilsson , Louise Krohn-Dehli , Anne Øvrehus , Lone Hagens Mygind , Lone W. Madsen , Jacob Søholm , Jeffrey V. Lazarus , Jannet van der Veen , Nina Weis

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引用次数: 0

Abstract

Background

Hepatitis C virus infection remains a major public health challenge, particularly among people who inject drugs. Despite the availability of highly effective direct-acting antiviral treatment, many remain undiagnosed and untreated. Self-collection for hepatitis C may improve testing uptake in this marginalized population. This study evaluated a peer-assisted, mail-based self-collection model integrated into a harm reduction service in Denmark.

Methods

This prospective observational study was conducted from June 2023 to December 2024. Participants were recruited through a peer-led mail-order harm reduction program operated by the non-governmental organization User’s Academy in Copenhagen. Self-collection kits with a dried blood spot finger-prick test were mailed to participants, with peer support provided throughout the care cascade. The primary outcome was the proportion returning the collected sample, and receiving results. Secondary outcomes included assistance with testing, HCV detection, treatment initiation, and cure. Factors associated with test completion were analyzed using adjusted odds ratios.

Results

A total of 126 participants were enrolled (median age 44 years; 29 percent women). Forty-four percent completed self-collection and received results; 52 percent of these received assistance. Among completers, 7 percent had detectable hepatitis C virus RNA, and all initiated treatment. Completion was associated with age 40 or older (adjusted odds ratio 3.31, 95 % confidence interval: 1.02 to 11.90) and enrollment in opioid agonist treatment (adjusted odds ratio 3.70, 95 % confidence interval: 0.99 to 15.70). Stimulant use (adjusted odds ratio 0.23, 95 % confidence interval: 0.05 to 0.88) and previous hepatitis C testing (adjusted odds ratio 0.18, 95 % confidence interval: 0.03 to 0.77) were associated with lower completion.

Conclusion

A peer-assisted, mail-based hepatitis C self-collection model is feasible and may improve testing and treatment uptake among people who inject drugs.

Abstract Image

查看原文本刊更多论文

丹麦减少伤害服务使用者之间的同侪递送邮购自我收集和与丙型肝炎病毒感染治疗的联系

丙型肝炎病毒感染仍然是一个重大的公共卫生挑战，特别是在注射吸毒者中。尽管有高效的直接抗病毒治疗，但许多人仍未得到诊断和治疗。自我收集丙型肝炎可能会提高这一边缘化人群对检测的接受程度。本研究评估了同行协助，基于邮件的自我收集模型集成到丹麦的危害减少服务。方法本前瞻性观察研究于2023年6月至2024年12月进行。参与者是通过哥本哈根非政府组织用户学院经营的由同行主导的邮购减少伤害方案招募的。通过邮寄给参与者带有干血点手指点刺测试的自我收集工具包，并在整个护理级联中提供同伴支持。主要观察指标为返回样本和接收结果的比例。次要结局包括协助检测、HCV检测、开始治疗和治愈。使用校正优势比分析与测试完成相关的因素。结果共纳入126名受试者(中位年龄44岁；29%是女性)。44%的人完成了自我收集并收到了结果；其中52%的人得到了援助。在完成者中，7%的人检测到丙型肝炎病毒RNA，并且所有人都开始了治疗。完成治疗与年龄≥40岁（校正优势比3.31,95%可信区间：1.02 ~ 11.90）和接受阿片类激动剂治疗相关（校正优势比3.70,95%可信区间：0.99 ~ 15.70）。兴奋剂使用（校正优势比0.23,95%可信区间：0.05至0.88）和既往丙型肝炎检测（校正优势比0.18,95%可信区间：0.03至0.77）与较低的完成率相关。结论基于邮件的同伴协助丙型肝炎自我收集模式是可行的，可以提高注射吸毒者的检测和治疗接受度。

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

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.