BACKGROUND AND AIM: Chronic hepatitis C virus (HCV) infection is one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. It is highly prevalent among injection drug users (IDUs) but is often undiagnosed because they represent an underprivileged group that faces multiple barriers to medical care. Here, we report the results of the New Life New Liver Project, which provides targeted HCV screening and education for ex-IDUs in the community. METHODS: Patients were recruited through the social worker networks and referrals by fellow ex-IDUs, and rapid diagnosis was based on point-of-care anti-HCV testing at rehabilitation centers. RESULTS: From 2009 to 2012, we served 234 subjects. One hundred thirty (56%) subjects were anti-HCV positive. The number needed to screen to detect one patient with positive anti-HCV was 1.8 (95% confidence interval, 1.6-2.0). However, only 69 (53%) HCV patients attended subsequent follow-up at regional hospitals, and 26 (20%) received antiviral therapy. Patients who attended follow-up were older, had higher education level and more active disease as evidenced by higher alanine aminotransferase, HCV RNA, and liver stiffness measurement by transient elastography. CONCLUSIONS: Targeted screening in ex-IDUs is effective in identifying patients with HCV infection in the community. Improvement in the referral system and introduction of interferon-free regimens are needed to increase treatment uptake.
BACKGROUND AND AIM: Chronic hepatitis C virus (HCV) infection is one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. It is highly prevalent among injection drug users (IDUs) but is often undiagnosed because they represent an underprivileged group that faces multiple barriers to medical care. Here, we report the results of the New Life New Liver Project, which provides targeted HCV screening and education for ex-IDUs in the community. METHODS:Patients were recruited through the social worker networks and referrals by fellow ex-IDUs, and rapid diagnosis was based on point-of-care anti-HCV testing at rehabilitation centers. RESULTS: From 2009 to 2012, we served 234 subjects. One hundred thirty (56%) subjects were anti-HCV positive. The number needed to screen to detect one patient with positive anti-HCV was 1.8 (95% confidence interval, 1.6-2.0). However, only 69 (53%) HCVpatients attended subsequent follow-up at regional hospitals, and 26 (20%) received antiviral therapy. Patients who attended follow-up were older, had higher education level and more active disease as evidenced by higher alanine aminotransferase, HCV RNA, and liver stiffness measurement by transient elastography. CONCLUSIONS: Targeted screening in ex-IDUs is effective in identifying patients with HCV infection in the community. Improvement in the referral system and introduction of interferon-free regimens are needed to increase treatment uptake.
Authors: Robert P Myers; Pam Crotty; Susanna Town; Janine English; Kevin Fonseca; Raymond Tellier; Mark G Swain; S Elizabeth McGregor; Steven J Heitman; Robert J Hilsden Journal: CMAJ Open Date: 2015-01-13
Authors: Stacey B Trooskin; Joanna Poceta; Caitlin M Towey; Annajane Yolken; Jennifer S Rose; Najia L Luqman; Ta-Wanda L Preston; Philip A Chan; Curt Beckwith; Sophie C Feller; Hwajin Lee; Amy S Nunn Journal: J Gen Intern Med Date: 2015-02-14 Impact factor: 5.128
Authors: Emma Day; Margaret Hellard; Carla Treloar; Julie Bruneau; Natasha K Martin; Anne Øvrehus; Olav Dalgard; Andrew Lloyd; John Dillon; Matt Hickman; Jude Byrne; Alain Litwin; Mojca Maticic; Philip Bruggmann; Havard Midgard; Brianna Norton; Stacey Trooskin; Jeffrey V Lazarus; Jason Grebely Journal: Liver Int Date: 2018-09-22 Impact factor: 5.828
Authors: Diana Hernández; Daniel J Feaster; Lauren Gooden; Antoine Douaihy; Raul Mandler; Sarah J Erickson; Tiffany Kyle; Louise Haynes; Robert Schwartz; Moupali Das; Lisa Metsch Journal: AIDS Behav Date: 2016-01
Authors: Jason Grebely; Julie Bruneau; Jeffrey V Lazarus; Olav Dalgard; Philip Bruggmann; Carla Treloar; Matthew Hickman; Margaret Hellard; Teri Roberts; Levinia Crooks; Håvard Midgard; Sarah Larney; Louisa Degenhardt; Hannu Alho; Jude Byrne; John F Dillon; Jordan J Feld; Graham Foster; David Goldberg; Andrew R Lloyd; Jens Reimer; Geert Robaeys; Marta Torrens; Nat Wright; Icro Maremmani; Brianna L Norton; Alain H Litwin; Gregory J Dore Journal: Int J Drug Policy Date: 2017-07-03
Authors: Masao Omata; Tatsuo Kanda; Osamu Yokosuka; Darrell Crawford; Mamun Al-Mahtab; Lai Wei; Alaaeldin Ibrahim; George K K Lau; Barjesh C Sharma; Saeed S Hamid; Wan-Long Chuang; A Kadir Dokmeci Journal: Hepatol Int Date: 2015-05-05 Impact factor: 9.029
Authors: Carissa E Chu; Feng Wu; Xi He; Kali Zhou; Yu Cheng; Weiping Cai; Elvin Geng; Paul Volberding; Joseph D Tucker Journal: Open Forum Infect Dis Date: 2016-06-24 Impact factor: 3.835
Authors: Dennis G Fisher; Kristen L Hess; Erlyana Erlyana; Grace L Reynolds; Catherine A Cummins; Todd A Alonzo Journal: Open Forum Infect Dis Date: 2015-07-07 Impact factor: 3.835