Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test-and-treat program.

Dried blood spots (DBS) are a reliable tool to diagnose viremic hepatitis C virus (HCV) infection. We evaluated the clinical performance of a DBS-based molecular assay for the assessment of cure and reinfection after on-site treatment at a harm reduction center (HRC). Genotyping from DBS samples was also assessed to discriminate reinfection from treatment failure.

HCV microelimination in harm reduction centres has benefits beyond HCV cure but is hampered by high reinfection rates.

Background & Aims: Significant scale-up of treatment among people who inject drugs (PWID) is crucial to achieve WHO HCV elimination targets. We explored the impact of on-site HCV diagnosis and treatment on PWID in an externalised hepatology clinic at the biggest harm reduction centre (HRC) in Barcelona attending to a marginalised PWID population with ongoing high-risk practices.

Methods: On-site HCV point-of-care testing was performed for diagnosis and treatment delivery.

Pilot hepatitis C micro-elimination strategy in Pakistani migrants in Catalonia through a community intervention.

Background And Aims: Pakistani migrants in Catalonia, Spain, could have high hepatitis C virus (HCV) prevalence. The aims of the HepClink study were (i) to implement and assess the quality of a micro-elimination strategy based on a community intervention and (ii) to obtain data from primary care (PC) registries as a baseline comparator.

Methods: The community intervention targeted Pakistani adults and consisted of education, screening and simplified access to treatment.

The hepatitis C care cascade among people who inject drugs accessing harm reduction services in Catalonia: Major gaps for migrants.

Background: This study aimed to describe the HCV cascade of care among people who inject drugs (PWID) in Catalonia, as well as to compare the observed gaps in care between Spanish-born and migrant PWID.

Methods: A cross-sectional study of PWID (N = 410) attending four harm reduction services (HRS) was performed in 2016-17 (HepCdetect II Study). Participants were tested for both HCV antibodies (rapid testing) and RNA (from dried blood spot samples).

Monitoring hepatitis C virus treatment rates in an Opioid Treatment Program: A longitudinal study.

Background: Direct-acting antivirals (DAAs) are recommended for the treatment of hepatitis C virus (HCV) infection in patients treated with methadone or buprenorphine.

Aim: To assess HCV treatment rates in an Opioid Treatment Program (OTP).

Methods: This longitudinal study included 501 patients (81.

Hepatitis C virus: Testing rate and attrition at linkage to specialized care, Catalonia, Spain 2011-2016.

Hepatitis C virus (HCV) screening through primary care providers (PCP) might increase linkage to specialized care. This study aimed to calculate HCV testing rate and prevalence of anti-HCV according to socio-demographic factors in primary care in Catalonia, Spain, from 2011 to 2016, and to identify the rate and determinants of attrition at linkage to specialized care. Patient data from 274 primary care centres (3414 PCP) were analysed, including socio-demographic information, morbidity, laboratory tests and treatments (1-Jan-2011 to 31-Dec-2016).

Women who inject drugs and violence: Need for an integrated response.

The aim of this study was to describe the prevalence of physical and/or sexual violence experienced by women who inject drugs (WWID) and identify associated factors. A cross-sectional study was conducted among 120 WWID in a network of harm reduction centres using an anonymous questionnaire. Oral fluid samples were also collected to estimate the prevalence of HIV and hepatitis C.

Utility of a one-step screening and diagnosis strategy for viremic HCV infection among people who inject drugs in Catalonia.

Background: In Catalonia (Spain), people who inject drugs (PWID) face numerous barriers to access to mainstream healthcare services for hepatitis C confirmatory diagnosis and treatment, so simplified testing strategies for viremic infection are urgently needed. Among PWID attending harm-reduction services in Catalonia, we aimed (i) to assess the utility of an in-house HCV-RNA detection assay on dried blood spots (DBS) as a one-step screening and confirmatory diagnosis strategy for hepatitis C, (ii) to estimate the prevalence of viremic HCV infection, and (iii) to identify factors associated with unawareness of viremic infection.

Methods: A cross-sectional study of current PWID (N  = 410) was performed in four harm-reduction services.

Drug consumption rooms in Catalonia: A comprehensive evaluation of social, health and harm reduction benefits.

Background And Aims: Despite the availability of several drug consumption rooms (DCR) in different European countries few epidemiological studies have evaluated their benefits. A network of DCR for people who inject drugs (PWID) has existed in Catalonia since 2000. We aimed to study the impact of frequently attending DCR on injecting in public, infectious risk (disposal of used syringes in safe places, sharing needles and/or injecting equipment), accessing drug dependence services and non-fatal overdoses.

Is systematic training in opioid overdose prevention effective?

The objectives were to analyze the knowledge about overdose prevention, the use of naloxone, and the number of fatal overdoses after the implementation of Systematic Training in Overdose Prevention (STOOP) program. We conducted a quasi-experimental study, and held face-to-face interviews before (n = 725) and after (n = 722) implementation of systematic training in two different samples of people who injected opioids attending harm reduction centers. We asked participants to list the main causes of overdose and the main actions that should be taken when witnessing an overdose.

Undiagnosed HIV and Hepatitis C infection in people who inject drugs: From new evidence to better practice.

Background: The objective of this study was to estimate the proportion of undiagnosed HIV or Hepatitis C virus (HCV) infection and to assess the risk factors associated with an undiagnosed infection.

Methods: A questionnaire was distributed among people who inject drugs (PWID) in harm reduction centres in Catalonia, Spain 2008-2012 (n=2243). Self-report of HIV and HCV was compared to oral fluid tests to calculate the proportion of undiagnosed infection.

Implementation of rapid HIV and HCV testing within harm reduction programmes for people who inject drugs: a pilot study.

Unlabelled: Including HCV and HIV rapid tests in harm reduction programmes (HRP) for people who inject drugs (PWID) can increase detection of these infections in high-risk populations who do not seek conventional health care.

Aims: To assess acceptability and feasibility of rapid HIV and HCV tests in HRP; to identify HIV and HCV prevalence rates in HRP; to identify the percentage of PWID with a reactive test that attend hospital for confirmation and follow-up. Rapid oral tests for HCV and HIV were offered to users of 13 HRP from both mobile units and facility-based centres.

High Prevalence and Incidence of HIV and HCV Among New Injecting Drug Users With a Large Proportion of Migrants--Is Prevention Failing?

Objectives: The aim of this study was to assess differences in the prevalence of HIV and HCV infection and associated risk factors between new (injecting for ≤5 years) and long-term injectors and to estimate HIV/HCV incidence among new injectors.

Methods: Cross-sectional study among people who inject drugs (PWID) who attended harm reduction centers in Catalonia in 2010-11. Anonymous questionnaires and oral fluid samples were collected.

Cross sectional study of factors associated to self-reported blood-borne infections among drug users.

Background: The study's aim was to estimate the self-reported prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV), and to describe their associated risk factors in a population of users of illicit drugs recruited in Catalonia- Spain, during 2012.

Methods: Cross-sectional study. People with illicit drugs use were selected in three different types of healthcare centres.

Coverage of overdose prevention programs for opiate users and injectors: a cross-sectional study.

Background: The use of opiates, particularly heroin, remains an important cause of morbidity and mortality. Half of the deaths among heroin consumers are attributed to overdose. In response to this problem, overdose prevention programs (OPPs) were designed.

Differences in illegal drug consumption between native and immigrants in a large sample of injected drug users in Catalonia (Spain).

The aims of this study were to describe illegal drug abuse patterns in relation to the migration process and use of drug treatment centers among immigrant injected drug users (IDUs) involved in harm reduction programs, and to compare the characteristics of immigrant and native IDUs. Cross-sectional study of 748 IDUs aged ≥18 years attending harm reduction centers between 2008 and 2009. We explored differences in socio-economic status, illegal drug consumption, health status and use of treatment centers in native versus immigrant IDUs.

Overdose prevention in injecting opioid users: the role of substance abuse treatment and training programs.

Objectives: Opioid overdose is still the first cause of preventable death among young men in Barcelona. Sound knowledge of opioid overdose prevention is important to avoid complications and deaths. This study aimed to identify the factors associated with limited knowledge of overdose prevention and to assess the possible effect of treatment and overdose prevention training programs on this variable.

Gender differences in HIV risk behaviours among intravenous drug users in Catalonia, Spain.

Objective: To describe gender differences in injection and sexual risks behaviours, and human immunodeficiency virus (HIV) and hepatitis C (HCV) prevalence among injecting drug users (IDU) in Catalonia, Spain.

Methods: Cross-sectional studies in 2008-2009 (n=748) and 2010-2011 (n=597) in the network of harm reduction centres. Face to face interviews were conducted and oral fluid samples were collected to estimate HIV/HCV prevalence.

[Characteristics of intravenous drug users who share injection equipment in Catalonia (Spain)].

Objectives: To estimate the prevalence of direct and indirect syringe sharing among intravenous drug users (IDUs) attending a harm reduction center in Catalonia (Spain) and to identify factors associated with risk behaviors.

Methods: A cross-sectional study was conducted between 2008 and 2009 in harm reduction centers. Behavioral data were collected using anonymous questionnaires administered by trained interviewers.

Sexually transmitted infections and sexual practices among injecting drug users in harm reduction centers in Catalonia.

Background: The objectives of the study were to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and sexual risk practices, and to identify factors associated with infection by C. trachomatis/N. gonorrhoeae.