Factors associated with HCV antiviral treatment uptake among participants of a community-based HCV programme for...

Area of Science:

• Hepatology
• Public Health
• Infectious Diseases

Background:

• Hepatitis C virus (HCV) treatment uptake is low among illicit drug users, a key demographic in developed countries.
• Limited evidence exists for HCV treatment models in substance users not in methadone maintenance programs.
• Marginalized populations with substance use and mental health comorbidities present unique challenges for HCV care.

Purpose of the Study:

• To identify factors associated with hepatitis C virus (HCV) antiviral treatment uptake.
• To evaluate the effectiveness of integrated, community-based health services for HCV treatment in a marginalized population.
• To assess treatment outcomes and associated factors in individuals with high rates of crack cocaine use.

Main Methods:

• Retrospective cohort study of 129 individuals in psycho-educational support groups and community health services.
• Analysis of factors influencing HCV antiviral treatment initiation and sustained virologic response (SVR).
• Assessment of healthcare access, immunization rates, and treatment outcomes based on drug use and housing status.

Main Results:

• Group participation significantly improved access to HCV specialists and hepatitis A/B immunization.
• The program achieved high SVR rates: 91% for HCV genotypes 2/3 and 54% for genotype 1.
• Stable housing was independently associated with initiating HCV treatment; no significant difference in SVR based on recent drug use.

Conclusions:

• Integrated, community-based health services can effectively improve HCV treatment uptake and outcomes in marginalized substance users.
• Addressing social determinants like stable housing is crucial for facilitating HCV treatment initiation.
• This model demonstrates successful HCV management in a population with complex comorbidities and substance use challenges.