- Title
- Progress towards Elimination of Hepatitis C Infection among People Who Inject Drugs in Australia: The ETHOS Engage Study
- Creator
- Valerio, Heather; Alavi, Maryam; Read, Phillip; Marks, Philippa; Degenhardt, Louisa; Hayllar, Jeremy; Reid, David; Gorton, Carla; Lam, Thao; Dore, Gregory J.; Grebely, Jason; Silk, David; Treloar, Carla; Martinello, Marianne; Milat, Andrew; Dunlop, Adrian; Holden, Jo; Henderson, Charles; Amin, Janaki
- Relation
- Clinical Infectious Diseases Vol. 73, Issue 1, p. e69-e78
- Publisher Link
- http://dx.doi.org/10.1093/cid/ciaa571
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Evaluating progress towards hepatitis C virus (HCV) elimination is critical. This study estimated prevalence of current HCV infection and HCV treatment uptake among people who inject drugs (PWID) in Australia. Methods: The Enhancing Treatment of Hepatitis C in Opioid Substitution Settings Engage is an observational study of PWID attending drug treatment clinics and needle and syringe programs (NSPs). Participants completed a questionnaire including self-reported treatment history and underwent point-of-care HCV RNA testing (Xpert HCV Viral Load Fingerstick; Cepheid). Results: Between May 2018 and September 2019, 1443 participants were enrolled (64% injected drugs in the last month, 74% receiving opioid agonist therapy [OAT]). HCV infection status was uninfected (28%), spontaneous clearance (16%), treatment-induced clearance (32%), and current infection (24%). Current HCV was more likely among people who were homeless (adjusted odds ratio, 1.47; 95% confidence interval, 1.00-2.16), incarcerated in the previous year (2.04; 1.38-3.02), and those injecting drugs daily or more (2.26; 1.43-2.42). Among those with previous chronic or current HCV, 66% (n = 520/788) reported HCV treatment. In adjusted analysis, HCV treatment was lower among females (.68;. 48-.95), participants who were homeless (.59;. 38-.96), and those injecting daily or more (.51;. 31-.89). People aged ≥45 years (1.46; 1.06-2.01) and people receiving OAT (2.62; 1.52-4.51) were more likely to report HCV treatment. Conclusions: Unrestricted direct-acting antiviral therapy access in Australia has yielded high treatment uptake among PWID attending drug treatment and NSPs, with a marked decline in HCV prevalence. To achieve elimination, PWID with greater marginalization may require additional support and tailored strategies to enhance treatment.
- Subject
- hepatitis C virus; direct-acting antivirals; people who inject drugs; hepatitis C elimination; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1475314
- Identifier
- uon:49510
- Identifier
- ISSN:1058-4838
- Language
- eng
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