Abstract
Objectives. To empirically determine a categorization of people who inject drug (PWIDs) recently infected with hepatitis C virus (HCV), in order to identify profiles most likely associated with early HCV treatment uptake. Methods. The study population was composed of HIV-negative PWIDs with a documented recent HCV infection. Eligibility criteria included being 18 years old or over, and having injected drugs in the previous 6 months preceding the estimated date of HCV exposure. Participant classification was carried out using a TwoStep cluster analysis. Results. From September 2007 to December 2011, 76 participants were included in the study. 60 participants were eligible for HCV treatment. Twenty-one participants initiated HCV treatment. The cluster analysis yielded 4 classes: class 1: Lukewarm health seekers dismissing HCV treatment offer; class 2: multisubstance users willing to shake off the hell; class 3: PWIDs unlinked to health service use; class 4: health seeker PWIDs willing to reverse the fate. Conclusion. Profiles generated by our analysis suggest that prior health care utilization, a key element for treatment uptake, differs between older and younger PWIDs. Such profiles could inform the development of targeted strategies to improve health outcomes and reduce HCV infection among PWIDs.
Highlights
The prevalence of hepatitis C virus (HCV) infection is estimated at 130–170 million people worldwide, currently driven by the growing number of infections among people who inject drugs (PWID) [1]
The study population was composed of PWIDs recently infected with HCV, enrolled in IMPACT, a study aiming at examining the effect of acute HCV infection and antiviral treatment on the behaviors and quality of life of PWIDs who have access to specific targeted health services
From September 2007 to December 2011, 76 participants infected with HCV within the previous six months were recruited in Montreal, Canada
Summary
The prevalence of HCV infection is estimated at 130–170 million people worldwide, currently driven by the growing number of infections among people who inject drugs (PWID) [1]. Before the advent of well-tolerated, orally administered HCV treatment regimens, traditional interferon-based antiviral treatment induced significant side effects that were deterring some patients from completing the treatment course. For patients who achieved sustained viral response equivalent to a cure, HCV treatment was shown to bring additional benefits, such as reduction of risky drug-consumption behaviours [3] and improvement of quality of life [4]. Within the three to five years, well-tolerated, orally administered interferon-free regimens will be available, improving the feasibility of treating difficult populations [5]. A recent modeling study by Martin and colleagues suggested that significant decreases in HCV prevalence can be accomplished by increasing simultaneously needle exchange program and opiate substitution therapy coverage on the one hand and HCV treatment coverage on the other hand [6]
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