Hepatitis C Virus Elimination in Methadone-treated Patients : Implementation of Hepatology Clinic in a Methadone Treatment Program
Copyright © 2022 American Society of Addiction Medicine..
OBJECTIVES: Patient ignorance and bureaucratic obstacles prevent initiation of hepatitis C virus (HCV) treatment in patients participating in methadone treatment program. Despite high safety and efficacy of currently available oral medications, the rate of patient-initiated treatment remains low. We evaluated the impact of an interventional program on treatment success rate and factors associated with treatment engagement.
METHODS: An intervention performed from 2018 to 2020 included an on-site Fibroscan and hepatologist evaluation, anti-viral HCV treatment initiation, and close support and follow-up by a dedicated team. Demographic and medical data were collected and comparison between patients who completed vs. patients who did not complete HCV treatment was done.
RESULTS: Fifty-nine out of 74 HCV polymerase chain reaction-positive patients (79.7%) were willing and capable of undergoing on-site hepatologist and Fibroscan evaluations. Twelve (25%) of the participants had cirrhosis, 2 of whom were decompensated. Fifty of the 57 patients that got an anti-viral medication prescription (87%) initiated the treatment. Premature treatment discontinuation was rare (3 patients), intention-to-treat sustain virologic response (SVR) rate was 81% and per-protocol SVR rate was 97%. The rate of treatment initiation during the intervention was significantly higher than the patients' self-initiation rate (44 vs 12 patients). The main factors associated with successful completion of the care cascade was full abstinence from street drugs for 6 months before treatment initiation.
CONCLUSIONS: Installing a hepatology clinic in an methadone treatment program center was associated with a 3-fold increase in the HCV treatment, with high adherence to treatment levels, and a high SVR rate. The main factor associated with low engagement to treatment was ongoing street drug use.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Journal of addiction medicine - 16(2022), 6 vom: 01. Nov., Seite e350-e355 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Katchman, Helena [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 18.11.2022 Date Revised 18.11.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/ADM.0000000000000975 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336973136 |
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| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American Society of Addiction Medicine. | ||
| 520 | |a OBJECTIVES: Patient ignorance and bureaucratic obstacles prevent initiation of hepatitis C virus (HCV) treatment in patients participating in methadone treatment program. Despite high safety and efficacy of currently available oral medications, the rate of patient-initiated treatment remains low. We evaluated the impact of an interventional program on treatment success rate and factors associated with treatment engagement | ||
| 520 | |a METHODS: An intervention performed from 2018 to 2020 included an on-site Fibroscan and hepatologist evaluation, anti-viral HCV treatment initiation, and close support and follow-up by a dedicated team. Demographic and medical data were collected and comparison between patients who completed vs. patients who did not complete HCV treatment was done | ||
| 520 | |a RESULTS: Fifty-nine out of 74 HCV polymerase chain reaction-positive patients (79.7%) were willing and capable of undergoing on-site hepatologist and Fibroscan evaluations. Twelve (25%) of the participants had cirrhosis, 2 of whom were decompensated. Fifty of the 57 patients that got an anti-viral medication prescription (87%) initiated the treatment. Premature treatment discontinuation was rare (3 patients), intention-to-treat sustain virologic response (SVR) rate was 81% and per-protocol SVR rate was 97%. The rate of treatment initiation during the intervention was significantly higher than the patients' self-initiation rate (44 vs 12 patients). The main factors associated with successful completion of the care cascade was full abstinence from street drugs for 6 months before treatment initiation | ||
| 520 | |a CONCLUSIONS: Installing a hepatology clinic in an methadone treatment program center was associated with a 3-fold increase in the HCV treatment, with high adherence to treatment levels, and a high SVR rate. The main factor associated with low engagement to treatment was ongoing street drug use | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 700 | 1 | |a Adelson, Miriam |e verfasserin |4 aut | |
| 700 | 1 | |a Avitan, Oren |e verfasserin |4 aut | |
| 700 | 1 | |a Mattatov, Mira |e verfasserin |4 aut | |
| 700 | 1 | |a Sason, Anat |e verfasserin |4 aut | |
| 700 | 1 | |a Levitt, Stela |e verfasserin |4 aut | |
| 700 | 1 | |a Dvorak, Lior |e verfasserin |4 aut | |
| 700 | 1 | |a Schreiber, Shaul |e verfasserin |4 aut | |
| 700 | 1 | |a Peles, Einat |e verfasserin |4 aut | |
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