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Targeted hepatitis C screening among ex‐injection drug users in the community
Author(s) -
Wong Vincent WaiSun,
Wong Grace LaiHung,
Chim Angel MeiLing,
Cheng TszFai,
Cheung Shirley WingYan,
Lai Carol ManSze,
Szeto Kylie JoanYi,
Tsang Sharon,
Wu Stephen HoChun,
Yan Kenneth KarLung,
Hui Alex Yui,
Yiu Desmond ChiHim,
Wu Brian BingYing,
Cheung David,
Chung Cedric SzeLai,
Lai Camey WaiMan,
Chan Henry LikYuen
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12355
Subject(s) - medicine , transient elastography , hepatitis c , hepatocellular carcinoma , hepatitis c virus , cirrhosis , liver disease , viral load , gastroenterology , immunology , virus , liver fibrosis
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 N ew L ife N ew L iver P roject, 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.