Year 2020 / Volume 112 / Number 7
Original
Linkage to care strategy for the micro-elimination of hepatitis C among parenteral drug users on methadone replacement therapy in Gipuzkoa

545-549

DOI: 10.17235/reed.2020.7194/2020

Ylenia Pérez Castaño, José Manuel Chouza Pérez, Vanesa Sanz Largo, Edurne Almandoz Cortajarena, Alexandra Gómez García, Francisco Javier Esandi González, Agustín Castiella Eguzkiza, Sandra Arranz Díaz, Itxaso Urtasun Lugea, Maria José Sánchez Iturri, Borja Gil Fernández, Luis Bujanda, Juan Arenas Ruiz-Tapiador,

Abstract
Introduction: parenteral drug users (PDUs) are a population with a high prevalence of infection with the hepatitis C virus (HCV) and significant difficulties to access to treatment. Opioid replacement therapy programs regularly monitor these individuals. Objective: to effectively treat this population using a directly observed therapy (DOT) and bringing resources closer to the methadone dispensing center in Gipuzkoa (Bitarte). Methods: all methadone users that were positive for anti-HCV antibodies were included in the study. Using a simplified circuit, a hepatologist visits the center with a Fibroscan® device and requests treatment following assessment. Treatment is dispensed at the addict center, under the supervision of a psychiatrist and nursing staff. Prevalence, population characteristics and circuit effectiveness were assessed. Results: Bitarte monitors 660 individuals. Of these, 73.6 % were positive for antibodies against HCV. The prevalence of viremic infection is 62.5 %. The predominant genotype was 1a, followed by 3. A total of 38.5 % had advanced fibrosis (F3 and F4) and 38 % of users admitted to active heroin use. In all, 82.07 % (174/212) of the population received treatment and 97 % had sustained viral response (SVR) after 12 weeks. No re-infections were recorded. Conclusions: the prevalence of viremic HCV infection among PDUs under treatment with methadone is 62 %. The linkage to care strategy was effective and > 80 % of the population with an active infection have been treated so far.
Share Button
New comment
Comments
No comments for this article
References
1. 1.Petruzziello A, Marigliano S, Loquercio G, el al. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. WJG 2016;22(34):7824.
2. Page K, Morris MD, Hahn JA, et al. Injection Drug Use and Hepatitis C Virus Infection in Young Adult Injectors: Using Evidence to Inform Comprehensive Prevention. Clin Infect Dis 2013;57(suppl_2):S32-8.
3. Wiessing L, Ferri M, Grady B, el al. Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention. PloS One 2014;9(7):e103345
4. Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet 2011;378(9791):571-83.
5. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet 2008;372(9651):1733-45.
6. Doyle JS, Aspinall EJ, Hutchinson SJ, et al. Global policy and access to new hepatitis C therapies for people who inject drugs. Int J Drug Policy 2015;26(11):1064-71.
7. Martin NK, Vickerman P, Dore GJ, et al. The hepatitis C virus epidemics in key populations (including people who inject drugs, prisoners and MSM): the use of direct-acting antivirals as treatment for prevention. Curr Opin HIV AIDS 2015;10(5):374-80.
8. Grebely J, Robaeys G, Bruggmann P, et al. Recommendations for the management of hepatitis C virus infection among people who inject drugs. Int J Drug Policy 2015;26(10):1028-38.
9. Falade-Nwulia O, Suarez-Cuervo C, Nelson DR, et al. Oral Direct-Acting Agent Therapy for Hepatitis C Virus Infection: A Systematic Review. Ann Intern Med 2017;166(9):637.
10. Grebely J, Bruneau J, Bruggmann P, et al. Elimination of hepatitis C virus infection among PWID: The beginning of a new era of interferon-free DAA therapy. Int J Drug Policy 2017;47:26-33.
11. Schackman BR, Gutkind S, Morgan JR, et al. Cost-effectiveness of hepatitis C screening and treatment linkage intervention in US methadone maintenance treatment programs. Drug Alcohol Depend 2018;185:411-20.
12. Young S, Wood E, Milloy M-J, et al. Hepatitis C cascade of care among people who inject drugs in Vancouver, Canada. Subst Abus 2018;39(4):461-8.
13. Low AJ, Mburu G, Welton NJ, et al. Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis. Clin Infect Dis 2016;63(8):1094-104.
14. Akiyama MJ, Norton BL, Arnsten JH, et al. Intensive Models of Hepatitis C Care for People Who Inject Drugs Receiving Opioid Agonist Therapy: A Randomized Controlled Trial. Ann Intern Med 2019;170(9):594.
15. Conway B, Prasad J, Reynolds R, et al. Directly Observed Therapy for the Management of HIV-Infected Patients in a Methadone Program. Clin Infect Dis 2004;38(Supplement_5):S402-8.
16. Midgard H, Weir A, Palmateer N, et al. HCV epidemiology in high-risk groups and the risk of reinfection. J Hepatol 2016;65(1):S33-45.
17. Rossi C, Butt ZA, Wong S, et alHepatitis C virus reinfection after successful treatment with direct-acting antiviral therapy in a large population-based cohort. J Hepatol 2018;69(5):1007-14.
Related articles
Citation tools
Pérez Castaño Y, Chouza Pérez J, Sanz Largo V, Almandoz Cortajarena E, Gómez García A, Esandi González F, et all. Linkage to care strategy for the micro-elimination of hepatitis C among parenteral drug users on methadone replacement therapy in Gipuzkoa. 7194/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1687 visits.
This article has been downloaded 204 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 27/04/2020

Accepted: 02/05/2020

Online First: 24/06/2020

Published: 08/07/2020

Article revision time: 2 days

Article Online First time: 58 days

Article editing time: 72 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology