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Treatment cascade for hepatitis C virus in young adult people who inject drugs in San Francisco: Low number treated

Abstract

OBJECTIVE: 

To understand the number of young adult people who inject drugs (PWID) with hepatitis C virus (HCV) infection accessing direct-acting antiviral (DAA) treatment and their barriers and facilitators to treatment uptake.

 

METHODS: 

Using prospective cohort data from young adult PWID in San Francisco with newly identified HCV infection, we calculated the number who: (i) accepted referral to DAA therapy, (ii) initiated DAA therapy, (iii) completed DAA therapy, and (iv) achieved sustained virologic response (SVR) or cure. Behavioral survey data identified possible barriers and facilitators to DAA therapy.

 

RESULTS: 

Of 60 young adult PWID with new HCV infection identified between February 2015 and January 2018, thirty accepted a referral to HCV care; five initiated and completed HCV treatment and achieved cure. Barriers to DAA uptake included fear of medical establishments, competing basic needs, and delaying care because they were feeling well.

 

CONCLUSION: 

While few HCV-positive young adult PWID engaged in DAA therapy, all those who did achieved cure. Youth-tailored services that overcome the stigma and marginalization related to injection drug use are needed to improve treatment uptake.

Authors

Morris MD1, Mirzazadeh A2, Evans JL3, Briceno A3, Coffin P4, Hahn JA5, Page KA6.

 

Drug Alcohol Depend. 2019 Feb 27;198:133-135. doi: 10.1016/j.drugalcdep.2019.02.008. [Epub ahead of print]

Author Information

  1. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA. Electronic address: Meghan.Morris@ucsf.edu.

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.

  3. Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.

  4. San Francisco Department of Public Health, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.

  5. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.

  6. Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.

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