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dc.contributor.authorWade, AJ
dc.contributor.authorMacdonald, DM
dc.contributor.authorDoyle, JS
dc.contributor.authorGordon, A
dc.contributor.authorRoberts, SK
dc.contributor.authorThompson, AJ
dc.contributor.authorHellard, ME
dc.date.accessioned2020-12-22T03:49:15Z
dc.date.available2020-12-22T03:49:15Z
dc.date.issued2015-11-12
dc.identifierpii: PONE-D-15-25998
dc.identifier.citationWade, A. J., Macdonald, D. M., Doyle, J. S., Gordon, A., Roberts, S. K., Thompson, A. J. & Hellard, M. E. (2015). The Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service. PLOS ONE, 10 (11), https://doi.org/10.1371/journal.pone.0142770.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/257936
dc.description.abstractBACKGROUND: Hepatitis C treatment uptake in Australia is low. To increase access to hepatitis C virus treatment for people who inject drugs, we developed a community-based, nurse-led service that linked a viral hepatitis service in a tertiary hospital to primary care clinics, and resulted in hepatitis C treatment provision in the community. METHODS: A retrospective cohort study of patients referred to the community hepatitis service was undertaken to determine the cascade of care. Logistic regression analyses were used to identify predictors of hepatitis C treatment uptake. RESULTS: Four hundred and sixty-two patients were referred to the community hepatitis service; 344 attended. Among the 279 attendees with confirmed chronic hepatitis C, 257 (99%) reported ever injecting drugs, and 124 (48%) injected in the last month. Of 201 (72%) patients who had their fibrosis staged, 63 (31%) had F3-F4 fibrosis. Fifty-five patients commenced hepatitis C treatment; 26 (47%) were current injectors and 25 (45%) had F3-F4 fibrosis. Nineteen of the 27 (70%) genotype 1 patients and 14 of the 26 (54%) genotype 3 patients eligible for assessment achieved a sustained virologic response. Advanced fibrosis was a significant predictor of treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006). CONCLUSIONS: Our community hepatitis service produced relatively high rates of fibrosis assessment, hepatitis C treatment uptake and cure, among people who inject drugs. These findings highlight the potential benefits of providing community-based hepatitis C care to people who inject drugs in Australia-benefits that should be realised as direct-acting antiviral agents become available.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleThe Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0142770
melbourne.affiliation.departmentUniversity General
melbourne.affiliation.departmentMedicine (St Vincent's)
melbourne.affiliation.departmentInfectious Diseases
melbourne.affiliation.facultyUniversity Services
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titlePLoS One
melbourne.source.volume10
melbourne.source.issue11
dc.rights.licenseCC BY
melbourne.elementsid1018283
melbourne.contributor.authorThompson, Alexander
melbourne.contributor.authorDoyle, Joseph
melbourne.contributor.authorHellard, Margaret
dc.identifier.eissn1932-6203
melbourne.accessrightsOpen Access


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