Determinants of hepatitis C antiviral effectiveness awareness among people who inject drugs in the direct-acting antiviral era

Heather Valerio, Andrew McAuley, Hamish Innes, Norah Palmateer, David J. Goldberg, Alison Munro, Avril Taylor, Sharon J. Hutchinson

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Abstract

Background & aims Although people who inject drugs (PWID) are at greatest risk of hepatitis C (HCV), treatment uptake in this population has historically been low. Highly effective direct acting antiviral (DAA) treatments for HCV have recently become available. Our aim was to assess the awareness among PWID of these new therapies and their effectiveness. Methods A national survey of PWID attending injecting equipment provision sites in Scotland during 2015–2016 included questions to gauge the awareness in this population of antiviral treatment and the high cure rates associated with new therapies (defined here as >80%). Results Among 2623 PWID, 92% had ever been tested for HCV. After excluding those ever treated for HCV (n¿=¿226), 79% were aware of HCV treatment. Awareness was more likely among those who had ever been tested and self-reported either a positive (adjusted odds ratio: 16.04, 95%CI 10.57–24.33) or negative (3.11, 2.30–4.22) test result, compared to those who were never tested. The minority of all respondents (17%) were aware of high cure rates. This awareness was more likely among those who had ever been in HCV specialist care (9.76, 5.13–18.60) and those who had not been in specialist care but had been tested and self-reported either a positive (3.91, 2.20–7.53) or negative (2.55, 1.35–4.81) test result, compared to those who had never been tested. Conclusion We found poor awareness of the high cure rates associated with DAAs among PWID in Scotland, despite relatively high rates of HCV testing in this population. Increased effort is needed to ensure population groups with high risk of HCV infection are fully informed of the highly effective antiviral medications now available to treat this chronic disease.
Original languageEnglish
Pages (from-to)115-122
Number of pages8
JournalInternational Journal of Drug Policy
Volume52
Early online date7 Feb 2018
DOIs
Publication statusPublished - Feb 2018

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Hepatitis C
Antiviral Agents
Pharmaceutical Preparations
Scotland
Population
Therapeutics
Population Groups
Chronic Disease
Odds Ratio
Drug Therapy
Equipment and Supplies
Infection
Surveys and Questionnaires

Keywords

  • hepatitis C
  • antivirals
  • injecting drug users

Cite this

@article{889a3fd1dddb47c1a2a4acf0187d07a6,
title = "Determinants of hepatitis C antiviral effectiveness awareness among people who inject drugs in the direct-acting antiviral era",
abstract = "Background & aims Although people who inject drugs (PWID) are at greatest risk of hepatitis C (HCV), treatment uptake in this population has historically been low. Highly effective direct acting antiviral (DAA) treatments for HCV have recently become available. Our aim was to assess the awareness among PWID of these new therapies and their effectiveness. Methods A national survey of PWID attending injecting equipment provision sites in Scotland during 2015–2016 included questions to gauge the awareness in this population of antiviral treatment and the high cure rates associated with new therapies (defined here as >80{\%}). Results Among 2623 PWID, 92{\%} had ever been tested for HCV. After excluding those ever treated for HCV (n¿=¿226), 79{\%} were aware of HCV treatment. Awareness was more likely among those who had ever been tested and self-reported either a positive (adjusted odds ratio: 16.04, 95{\%}CI 10.57–24.33) or negative (3.11, 2.30–4.22) test result, compared to those who were never tested. The minority of all respondents (17{\%}) were aware of high cure rates. This awareness was more likely among those who had ever been in HCV specialist care (9.76, 5.13–18.60) and those who had not been in specialist care but had been tested and self-reported either a positive (3.91, 2.20–7.53) or negative (2.55, 1.35–4.81) test result, compared to those who had never been tested. Conclusion We found poor awareness of the high cure rates associated with DAAs among PWID in Scotland, despite relatively high rates of HCV testing in this population. Increased effort is needed to ensure population groups with high risk of HCV infection are fully informed of the highly effective antiviral medications now available to treat this chronic disease.",
keywords = "hepatitis C, antivirals, injecting drug users",
author = "Heather Valerio and Andrew McAuley and Hamish Innes and Norah Palmateer and Goldberg, {David J.} and Alison Munro and Avril Taylor and Hutchinson, {Sharon J.}",
note = "Acceptance from webpage AAM: 12m embargo",
year = "2018",
month = "2",
doi = "10.1016/j.drugpo.2017.12.014",
language = "English",
volume = "52",
pages = "115--122",
journal = "International Journal of Drug Policy",
issn = "0955-3959",
publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Determinants of hepatitis C antiviral effectiveness awareness among people who inject drugs in the direct-acting antiviral era

AU - Valerio, Heather

AU - McAuley, Andrew

AU - Innes, Hamish

AU - Palmateer, Norah

AU - Goldberg, David J.

AU - Munro, Alison

AU - Taylor, Avril

AU - Hutchinson, Sharon J.

N1 - Acceptance from webpage AAM: 12m embargo

PY - 2018/2

Y1 - 2018/2

N2 - Background & aims Although people who inject drugs (PWID) are at greatest risk of hepatitis C (HCV), treatment uptake in this population has historically been low. Highly effective direct acting antiviral (DAA) treatments for HCV have recently become available. Our aim was to assess the awareness among PWID of these new therapies and their effectiveness. Methods A national survey of PWID attending injecting equipment provision sites in Scotland during 2015–2016 included questions to gauge the awareness in this population of antiviral treatment and the high cure rates associated with new therapies (defined here as >80%). Results Among 2623 PWID, 92% had ever been tested for HCV. After excluding those ever treated for HCV (n¿=¿226), 79% were aware of HCV treatment. Awareness was more likely among those who had ever been tested and self-reported either a positive (adjusted odds ratio: 16.04, 95%CI 10.57–24.33) or negative (3.11, 2.30–4.22) test result, compared to those who were never tested. The minority of all respondents (17%) were aware of high cure rates. This awareness was more likely among those who had ever been in HCV specialist care (9.76, 5.13–18.60) and those who had not been in specialist care but had been tested and self-reported either a positive (3.91, 2.20–7.53) or negative (2.55, 1.35–4.81) test result, compared to those who had never been tested. Conclusion We found poor awareness of the high cure rates associated with DAAs among PWID in Scotland, despite relatively high rates of HCV testing in this population. Increased effort is needed to ensure population groups with high risk of HCV infection are fully informed of the highly effective antiviral medications now available to treat this chronic disease.

AB - Background & aims Although people who inject drugs (PWID) are at greatest risk of hepatitis C (HCV), treatment uptake in this population has historically been low. Highly effective direct acting antiviral (DAA) treatments for HCV have recently become available. Our aim was to assess the awareness among PWID of these new therapies and their effectiveness. Methods A national survey of PWID attending injecting equipment provision sites in Scotland during 2015–2016 included questions to gauge the awareness in this population of antiviral treatment and the high cure rates associated with new therapies (defined here as >80%). Results Among 2623 PWID, 92% had ever been tested for HCV. After excluding those ever treated for HCV (n¿=¿226), 79% were aware of HCV treatment. Awareness was more likely among those who had ever been tested and self-reported either a positive (adjusted odds ratio: 16.04, 95%CI 10.57–24.33) or negative (3.11, 2.30–4.22) test result, compared to those who were never tested. The minority of all respondents (17%) were aware of high cure rates. This awareness was more likely among those who had ever been in HCV specialist care (9.76, 5.13–18.60) and those who had not been in specialist care but had been tested and self-reported either a positive (3.91, 2.20–7.53) or negative (2.55, 1.35–4.81) test result, compared to those who had never been tested. Conclusion We found poor awareness of the high cure rates associated with DAAs among PWID in Scotland, despite relatively high rates of HCV testing in this population. Increased effort is needed to ensure population groups with high risk of HCV infection are fully informed of the highly effective antiviral medications now available to treat this chronic disease.

KW - hepatitis C

KW - antivirals

KW - injecting drug users

U2 - 10.1016/j.drugpo.2017.12.014

DO - 10.1016/j.drugpo.2017.12.014

M3 - Article

VL - 52

SP - 115

EP - 122

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

ER -