TY  - JOUR
AU  - Wade, AJ
AU  - Macdonald, DM
AU  - Doyle, JS
AU  - Gordon, A
AU  - Roberts, SK
AU  - Thompson, AJ
AU  - Hellard, ME
Y2  - 2020/12/22
Y1  - 2015/11/12
SN  - 1932-6203
UR  - http://hdl.handle.net/11343/257936
AB  - BACKGROUND: 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.
LA  - English
PB  - PUBLIC LIBRARY SCIENCE
T1  - The Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service
DO  - 10.1371/journal.pone.0142770
IS  - PLoS One
VL  - 10
IS  - 11
L1  - /bitstream/handle/11343/257936/PMC4642931.pdf?sequence=1&isAllowed=y
ER  -