BACKGROUND: Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary-care-based strategies for the management of HCV do not effectively target this vulnerable population. AIMS: To evaluate the feasibility, safety and efficacy of a primary-care-based model for the delivery of HCV services including anti-viral therapy to injecting drug users. METHODS: A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary-care-based hepatitis service and drug workers and general practitioners. Three hundred and fifty-three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti-viral treatment, and number of patients treated. RESULTS: 174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically-infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti-viral treatment and 30 have so far been treated. Outcomes of anti-viral treatment are comparable with those obtained in secondary care settings. CONCLUSION: A primary-care-based model offers a new paradigm for the treatment of HCV in injecting drug users.
BACKGROUND: Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary-care-based strategies for the management of HCV do not effectively target this vulnerable population. AIMS: To evaluate the feasibility, safety and efficacy of a primary-care-based model for the delivery of HCV services including anti-viral therapy to injecting drug users. METHODS: A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary-care-based hepatitis service and drug workers and general practitioners. Three hundred and fifty-three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti-viral treatment, and number of patients treated. RESULTS: 174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically-infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti-viral treatment and 30 have so far been treated. Outcomes of anti-viral treatment are comparable with those obtained in secondary care settings. CONCLUSION: A primary-care-based model offers a new paradigm for the treatment of HCV in injecting drug users.
Authors: Rositsa B Dimova; Marija Zeremski; Ira M Jacobson; Holly Hagan; Don C Des Jarlais; Andrew H Talal Journal: Clin Infect Dis Date: 2012-12-07 Impact factor: 9.079
Authors: Jason Grebely; Geert Robaeys; Philip Bruggmann; Alessio Aghemo; Markus Backmund; Julie Bruneau; Jude Byrne; Olav Dalgard; Jordan J Feld; Margaret Hellard; Matthew Hickman; Achim Kautz; Alain Litwin; Andrew R Lloyd; Stefan Mauss; Maria Prins; Tracy Swan; Martin Schaefer; Lynn E Taylor; Gregory J Dore Journal: Int J Drug Policy Date: 2015-07-17
Authors: Adam Isaiah Newman; Shelley Beckstead; David Beking; Susan Finch; Tina Knorr; Carol Lynch; Meredith MacKenzie; Daphne Mayer; Brenda Melles; Ron Shore Journal: Can J Gastroenterol Date: 2013-04 Impact factor: 3.522