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ITTREAT ( I ntegrated Community T est ‐ Stage ‐ TREAT ) Hepatitis C service for people who use drugs: Real‐world outcomes
Author(s) -
O'Sullivan Margaret,
Jones AnnaMarie,
Gage Heather,
Jordan Jake,
MacPepple Ekelechi,
Williams Hugh,
Verma Sumita
Publication year - 2020
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14403
Subject(s) - medicine , hepatitis c , quality of life (healthcare) , mental health , hepatitis c virus , psychiatry , immunology , virus , nursing
Background/aims Direct‐acting antivirals (DAAs) provide an unprecedented opportunity for a “find‐and‐treat strategy.” We aimed to report real‐world clinical, patient reported and health economic outcomes of community‐based hepatitis C virus (HCV) screening/treatment in people who use drugs (PWUDs). Methods Project ITTREAT (2013‐2021), established at a drug and alcohol treatment centre, offered a comprehensive service. Generic (SF‐12v2 and EQ‐5D‐5L) and liver‐specific (SFLDQoL) health‐related quality of life (HRQoL) were assessed before and after HCV treatment. Costs/case detected and cured were calculated. Primary outcome measure was sustained virological response (SVR) (intention to treat). Results Till March 2018, 573 individuals recruited, 462 (81%) males, mean age 40.5 ± 10.0 years. Of the 125 treated, 115 (92%) had past/current history of injecting drug use, 88 (70%) were receiving opioid agonist treatment and 50 (40%) were homeless. Twenty‐six per cent received interferon‐based and 74% DAA‐only regimens. SVR (ITT) was 87% (90% with DAAs). Service uptake/HCV treatment completion rates were >95%, HCV reinfection being 2.63/100 person years (95% CI 0.67‐10.33). HRQoL improved significantly at end of treatment (EOT) in those with SVR: SFLDQoL (symptoms, memory, distress, loneliness, hopelessness, sleep and stigma) ( P