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Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting
| Content Provider | Scilit |
|---|---|
| Author | Socías, M. Eugenia Ti, Lianping Wood, Evan Nosova, Ekaterina Hull, Mark Hayashi, Kanna Debeck, Kora Milloy, M‐J |
| Copyright Year | 2019 |
| Description | Journal: Liver International Despite the high burden of hepatitis C virus (HCV) infection among people who inject drugs (PWID), uptake of interferon-based therapies has been extremely low. Increasing availability of direct-acting antiviral (DAA)-based therapies offers the possibility of rapid treatment expansion with the goal of controlling the HCV epidemic. We evaluated DAA-based treatment uptake among HCV-positive PWID in Vancouver after introduction of DAAs in the government drug formulary. Using data from three cohorts of PWID in Vancouver, Canada, we investigated factors associated with DAA-therapies uptake among participants with HCV between April 2015-November 2017. Of 915 HCV-positive PWID, 611 (66.8%) were recent PWID and 369 (40.3%) had HIV coinfection. During the study period, 146 (16.0%) initiated DAA-therapies, a rate of 6.0 per 100 person-year, with higher initiation rates among non-recent PWID and an increasing trend over time. In multivariable analysis, HIV coinfection (Adjusted Odds Ratio [AOR] = 2.29, 95% Confidence Interval [CI]: 1.55–3.40), white race (AOR=1.56, 95%CI: 1.05–2.35), and engagement in HCV care (AOR=1.94, 95%CI: 1.31–2.90) were positively associated with DAA-therapies uptake, while high-risk drinking (AOR=0.47, 95%CI: 0.23–0.88) and daily crack use were negatively associated (AOR=0.41, 95%CI: 0.17–0.85). Among recent PWID, engagement in opioid agonist therapy emerged as an independent correlate of DAA uptake. Despite increases in HCV treatment uptake among PWID after the introduction of DAAs in our setting, disparities in access remain. Social-structural and behavioral barriers to HCV care should be addressed for the success of any HCV elimination strategy. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640076/pdf |
| Ending Page | 1407 |
| Page Count | 8 |
| Starting Page | 1400 |
| e-ISSN | 14783231 |
| DOI | 10.1111/liv.14043 |
| Journal | Liver International |
| Issue Number | 8 |
| Volume Number | 39 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2019-02-24 |
| Access Restriction | Open |
| Subject Keyword | Journal: Liver International People Who Inject Drugs Direct-acting-antiviral |
| Content Type | Text |
| Resource Type | Article |
