Shelley N Facente1,2, Sheena Patel3, Jennifer Hecht4, Erin Wilson5, Willi McFarland3,5, Kimberly Page6, Peter Vickerman7, Hannah Fraser7, Katie Burk5, Meghan D Morris3. 1. School of Public Health, Division of Epidemiology and Biostatistics, University of California Berkeley, Berkeley, California, USA. 2. Facente Consulting, Richmond, California, USA. 3. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA. 4. San Francisco AIDS Foundation, San Francisco, California, USA. 5. San Francisco Department of Public Health, San Francisco, California, USA. 6. University of New Mexico, Albuquerque, New Mexico, USA. 7. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Abstract
BACKGROUND: To achieve elimination of hepatitis C virus (HCV) infection, limited resources can be best allocated through estimation of "care cascades" among groups disproportionately affected. In San Francisco and elsewhere, these groups include young (age ≤ 30 years) people who inject drugs (YPWID), men who have sex with men who inject drugs (MSM-IDU), and low-income trans women. METHODS: We developed cross-sectional HCV care cascades for YPWID, MSM-IDU, and trans women using diverse data sources. Population sizes were estimated using an inverse variance-weighted average of estimates from the peer-reviewed literature between 2013 and 2019. Proportions of past/current HCV infection, diagnosed infection, treatment initiation, and evidence of cure (sustained virologic response at 12 weeks posttreatment) were estimated from the literature using data from 7 programs and studies in San Francisco between 2015 and 2020. RESULTS: The estimated number of YPWID in San Francisco was 3748; 58.4% had past/current HCV infection, of whom 66.4% were diagnosed with current infection, 9.1% had initiated treatment, and 50% had confirmed cure. The corresponding figures for the 8135 estimated MSM-IDU were: 29.4% with past/current HCV infection, 70.3% diagnosed with current infection, 28.4% initiated treatment, and 38.9% with confirmed cure. For the estimated 951 low-income trans women, 24.8% had past/current HCV infection, 68.9% were diagnosed with current infection, 56.5% initiated treatment, and 75.5% had confirmed cure. CONCLUSIONS: In all 3 populations, diagnosis rates were relatively high; however, attention is needed to urgently increase treatment initiation in all groups, with a particular unmet need among YPWID.
BACKGROUND: To achieve elimination of hepatitis C virus (HCV) infection, limited resources can be best allocated through estimation of "care cascades" among groups disproportionately affected. In San Francisco and elsewhere, these groups include young (age ≤ 30 years) people who inject drugs (YPWID), men who have sex with men who inject drugs (MSM-IDU), and low-income trans women. METHODS: We developed cross-sectional HCV care cascades for YPWID, MSM-IDU, and trans women using diverse data sources. Population sizes were estimated using an inverse variance-weighted average of estimates from the peer-reviewed literature between 2013 and 2019. Proportions of past/current HCV infection, diagnosed infection, treatment initiation, and evidence of cure (sustained virologic response at 12 weeks posttreatment) were estimated from the literature using data from 7 programs and studies in San Francisco between 2015 and 2020. RESULTS: The estimated number of YPWID in San Francisco was 3748; 58.4% had past/current HCV infection, of whom 66.4% were diagnosed with current infection, 9.1% had initiated treatment, and 50% had confirmed cure. The corresponding figures for the 8135 estimated MSM-IDU were: 29.4% with past/current HCV infection, 70.3% diagnosed with current infection, 28.4% initiated treatment, and 38.9% with confirmed cure. For the estimated 951 low-income trans women, 24.8% had past/current HCV infection, 68.9% were diagnosed with current infection, 56.5% initiated treatment, and 75.5% had confirmed cure. CONCLUSIONS: In all 3 populations, diagnosis rates were relatively high; however, attention is needed to urgently increase treatment initiation in all groups, with a particular unmet need among YPWID.
Authors: Judith A Hahn; Kimberly Page-Shafer; Paula J Lum; Philippe Bourgois; Ellen Stein; Jennifer L Evans; Michael P Busch; Leslie H Tobler; Bruce Phelps; Andrew R Moss Journal: J Infect Dis Date: 2002-11-04 Impact factor: 5.226
Authors: Shelley N Facente; Rachel Grinstein; Roberta Bruhn; Zhanna Kaidarova; Erin Wilson; Jennifer Hecht; Katie Burk; Eduard Grebe; Meghan D Morris Journal: PLoS One Date: 2022-05-11 Impact factor: 3.752
Authors: Alison R Ohringer; David P Serota; Rachel L McLean; Lauren J Stockman; James P Watt Journal: BMC Public Health Date: 2021-07-21 Impact factor: 3.295