Targeted hepatitis C screening among ex-injection drug users in the community
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 barrier...
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Published in | Journal of gastroenterology and hepatology Vol. 29; no. 1; pp. 116 - 120 |
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Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Australia
Blackwell Publishing Ltd
01.01.2014
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Subjects | |
Online Access | Get full text |
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Summary: | 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 New Life New Liver Project, 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. |
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Bibliography: | ark:/67375/WNG-54FD0F1R-R ArticleID:JGH12355 istex:F65930BB5201A8DBBB0E277F2C7DAAB55843A3FD Food and Health Bureau of the Government of the Hong Kong SAR - No. 6902849 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 |
ISSN: | 0815-9319 1440-1746 |
DOI: | 10.1111/jgh.12355 |