Introduction: Data on the epidemiology of hepatitis C among individuals who use drugs in low-threshold settings are lacking, although crucial to assess the burden of disease and aid in the design of treatment strategies.
Objective: The aim of this study was to characterize the epidemiology and disease related to hepatitis C in a population attending a low-threshold methadone program.
Materials And Methods: A cross-sectional study in the population attending the Mobile Low-Threshold Methadone Program in Lisbon, Portugal, was carried out. The survey included assessment of risk factors for infection with hepatitis C virus (HCV) and liver disease, HCV serology and RNA detection, HCV genotyping, and liver disease staging.
Results: A total of 825 participants were enrolled, 81.3% men, mean age 44.5 years. Injecting drug use (IDU) was reported by 58.4% - among these, 28.2% were people who inject drugs. Excessive drinking and HIV coinfection were reported by 33.4 and 15.9%, respectively. Among participants with active infection, 16.9% were followed up in hospital consultation. The overall seroprevalence for HCV was 67.6% (94.2% in IDU, 30.0% in non-IDU, 97.1% in people who inject drugs, and 75.6% in excessive drinkers). Among seropositives for HCV, active infection was present in 68.4%. Among individuals with active infection, the most common genotypes were 1a (45.3%) and 3a (28.7%), whereas 30% had severe liver fibrosis or cirrhosis. Age 45 years or older, HCV genotype 3, and coinfection with HIV were significant predictors of cirrhosis.
Conclusion: This population has a high burden of hepatitis C and several characteristics that favor dissemination of infection. Healthcare strategies are urgently needed to address hepatitis C in this setting.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MEG.0000000000000843 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Patient experiences of buprenorphine dispensing from a mobile medical unit.
Addict Sci Clin Pract
July 2024
College of Pharmacy, Department of Pharmacy Practice & American Medical Association, University of Illinois at Chicago, 833 S. Wood St, Chicago, IL, 60612, USA.
Background: Overdose deaths continue to rise within the United States, despite effective treatments such as buprenorphine and methadone for opioid use disorder (OUD). Mobile medical units with the ability to dispense buprenorphine have been developed to engage patients and eliminate barriers to accessing OUD treatment. This study reports survey responses of patients of a mobile medical unit dispensing buprenorphine in areas of Chicago, IL with high overdose rates.
View Article and Find Full Text PDFPharmacy-based expansion of buprenorphine access.
J Subst Use Addict Treat
February 2024
Medicine and Epidemiology, Brown University, United States of America; The Miriam and Rhode Island Hospitals, 164 Summit Ave, Providence, RI 02906, United States of America. Electronic address:
Introduction: Access to evidence-based medication treatment is a challenge for most Americans with opioid use disorder. New models of collaborative care that actively incorporate pharmacists are being trialed.
Methods: We author a commentary based on our experiences providing clinical care as part of a randomized controlled trial of pharmacy-based addiction care.
Looking at the Molecular Target of NS5A Inhibitors throughout a Population Highly Affected with Hepatitis C Virus.
Pathogens
May 2023
Reference Laboratory of HIV and Hepatitis B and C, Department of Infectious Diseases, National Institute of Health, Av. Padre Cruz, P-1649-016 Lisbon, Portugal.
Hepatitis C virus (HCV) is associated with liver damage and an increased progression rate to cirrhosis and hepatocellular carcinoma. In Portugal, it is prevalent in vulnerable populations such as injection drug users (IDU). HCV is characterized by a high intra-host variability, and the selecting driving forces could select variants containing resistance-associated substitutions (RAS) that reduce treatment effectiveness.
View Article and Find Full Text PDFPoint-of-care hepatitis C reflex testing and treatment referral in methadone clinic settings in Hong Kong-a pilot study.
IJID Reg
December 2022
Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Objectives: People who inject drugs (PWID) constitute a population group with a high hepatitis C virus (HCV) burden. With the objectives of assessing the HCV prevalence in PWID and determining the proportion requiring treatment who could be linked to care, this study piloted onsite reflex HCV testing at low threshold methadone clinics, with prompt referral of HCV RNA-positive participants for treatment.
Methods: This was a prospective study on methadone clinic attendees in Hong Kong.
Pharmacotherapy of Opioid Use Disorder-Update and Current Challenges.
Psychiatr Clin North Am
September 2022
Department of Medicine, Division of Addiction Medicine, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building, East Tower, 2nd Floor, Baltimore, MD 21224, USA.
The incidence of opioid use disorder (OUD) and overdose deaths is rising yearly within the United States. Many cases are associated with illicitly manufactured fentanyl use. In addition to offering patients medications for OUD (methadone, buprenorphine, and naltrexone), the approach to this epidemic should involve increasing provider awareness and education about substance use disorders, expanding urine toxicology screens to test for fentanyl, and using low-threshold treatment approaches.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!