Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention st...
Ausführliche Beschreibung
Autor*in: |
Francesco Giuseppe Foschi [verfasserIn] Alberto Borghi [verfasserIn] Alberto Grassi [verfasserIn] Arianna Lanzi [verfasserIn] Elvira Speranza [verfasserIn] Teo Vignoli [verfasserIn] Lucia Napoli [verfasserIn] Deanna Olivoni [verfasserIn] Michele Sanza [verfasserIn] Edoardo Polidori [verfasserIn] Giovanni Greco [verfasserIn] Paolo Bassi [verfasserIn] Francesco Cristini [verfasserIn] Giorgio Ballardini [verfasserIn] Mattia Altini [verfasserIn] Fabio Conti [verfasserIn] on behalf of MITH Group [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2021 |
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Übergeordnetes Werk: |
In: Journal of Clinical Medicine - MDPI AG, 2013, 10(2021), 17, p 4001 |
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Übergeordnetes Werk: |
volume:10 ; year:2021 ; number:17, p 4001 |
Links: |
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DOI / URN: |
10.3390/jcm10174001 |
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Katalog-ID: |
DOAJ07199422X |
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520 | |a Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. | ||
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10.3390/jcm10174001 doi (DE-627)DOAJ07199422X (DE-599)DOAJ55bd77bea46245eba572df0630fab999 DE-627 ger DE-627 rakwb eng Francesco Giuseppe Foschi verfasserin aut Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. HCV treatment HCV microelimination drug users reinfection people who inject drugs direct acting antivirals Medicine R Alberto Borghi verfasserin aut Alberto Grassi verfasserin aut Arianna Lanzi verfasserin aut Elvira Speranza verfasserin aut Teo Vignoli verfasserin aut Lucia Napoli verfasserin aut Deanna Olivoni verfasserin aut Michele Sanza verfasserin aut Edoardo Polidori verfasserin aut Giovanni Greco verfasserin aut Paolo Bassi verfasserin aut Francesco Cristini verfasserin aut Giorgio Ballardini verfasserin aut Mattia Altini verfasserin aut Fabio Conti verfasserin aut on behalf of MITH Group verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 17, p 4001 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:17, p 4001 https://doi.org/10.3390/jcm10174001 kostenfrei https://doaj.org/article/55bd77bea46245eba572df0630fab999 kostenfrei https://www.mdpi.com/2077-0383/10/17/4001 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 17, p 4001 |
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10.3390/jcm10174001 doi (DE-627)DOAJ07199422X (DE-599)DOAJ55bd77bea46245eba572df0630fab999 DE-627 ger DE-627 rakwb eng Francesco Giuseppe Foschi verfasserin aut Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. HCV treatment HCV microelimination drug users reinfection people who inject drugs direct acting antivirals Medicine R Alberto Borghi verfasserin aut Alberto Grassi verfasserin aut Arianna Lanzi verfasserin aut Elvira Speranza verfasserin aut Teo Vignoli verfasserin aut Lucia Napoli verfasserin aut Deanna Olivoni verfasserin aut Michele Sanza verfasserin aut Edoardo Polidori verfasserin aut Giovanni Greco verfasserin aut Paolo Bassi verfasserin aut Francesco Cristini verfasserin aut Giorgio Ballardini verfasserin aut Mattia Altini verfasserin aut Fabio Conti verfasserin aut on behalf of MITH Group verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 17, p 4001 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:17, p 4001 https://doi.org/10.3390/jcm10174001 kostenfrei https://doaj.org/article/55bd77bea46245eba572df0630fab999 kostenfrei https://www.mdpi.com/2077-0383/10/17/4001 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 17, p 4001 |
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10.3390/jcm10174001 doi (DE-627)DOAJ07199422X (DE-599)DOAJ55bd77bea46245eba572df0630fab999 DE-627 ger DE-627 rakwb eng Francesco Giuseppe Foschi verfasserin aut Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. HCV treatment HCV microelimination drug users reinfection people who inject drugs direct acting antivirals Medicine R Alberto Borghi verfasserin aut Alberto Grassi verfasserin aut Arianna Lanzi verfasserin aut Elvira Speranza verfasserin aut Teo Vignoli verfasserin aut Lucia Napoli verfasserin aut Deanna Olivoni verfasserin aut Michele Sanza verfasserin aut Edoardo Polidori verfasserin aut Giovanni Greco verfasserin aut Paolo Bassi verfasserin aut Francesco Cristini verfasserin aut Giorgio Ballardini verfasserin aut Mattia Altini verfasserin aut Fabio Conti verfasserin aut on behalf of MITH Group verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 17, p 4001 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:17, p 4001 https://doi.org/10.3390/jcm10174001 kostenfrei https://doaj.org/article/55bd77bea46245eba572df0630fab999 kostenfrei https://www.mdpi.com/2077-0383/10/17/4001 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 17, p 4001 |
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10.3390/jcm10174001 doi (DE-627)DOAJ07199422X (DE-599)DOAJ55bd77bea46245eba572df0630fab999 DE-627 ger DE-627 rakwb eng Francesco Giuseppe Foschi verfasserin aut Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. HCV treatment HCV microelimination drug users reinfection people who inject drugs direct acting antivirals Medicine R Alberto Borghi verfasserin aut Alberto Grassi verfasserin aut Arianna Lanzi verfasserin aut Elvira Speranza verfasserin aut Teo Vignoli verfasserin aut Lucia Napoli verfasserin aut Deanna Olivoni verfasserin aut Michele Sanza verfasserin aut Edoardo Polidori verfasserin aut Giovanni Greco verfasserin aut Paolo Bassi verfasserin aut Francesco Cristini verfasserin aut Giorgio Ballardini verfasserin aut Mattia Altini verfasserin aut Fabio Conti verfasserin aut on behalf of MITH Group verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 17, p 4001 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:17, p 4001 https://doi.org/10.3390/jcm10174001 kostenfrei https://doaj.org/article/55bd77bea46245eba572df0630fab999 kostenfrei https://www.mdpi.com/2077-0383/10/17/4001 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 17, p 4001 |
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10.3390/jcm10174001 doi (DE-627)DOAJ07199422X (DE-599)DOAJ55bd77bea46245eba572df0630fab999 DE-627 ger DE-627 rakwb eng Francesco Giuseppe Foschi verfasserin aut Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. HCV treatment HCV microelimination drug users reinfection people who inject drugs direct acting antivirals Medicine R Alberto Borghi verfasserin aut Alberto Grassi verfasserin aut Arianna Lanzi verfasserin aut Elvira Speranza verfasserin aut Teo Vignoli verfasserin aut Lucia Napoli verfasserin aut Deanna Olivoni verfasserin aut Michele Sanza verfasserin aut Edoardo Polidori verfasserin aut Giovanni Greco verfasserin aut Paolo Bassi verfasserin aut Francesco Cristini verfasserin aut Giorgio Ballardini verfasserin aut Mattia Altini verfasserin aut Fabio Conti verfasserin aut on behalf of MITH Group verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 17, p 4001 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:17, p 4001 https://doi.org/10.3390/jcm10174001 kostenfrei https://doaj.org/article/55bd77bea46245eba572df0630fab999 kostenfrei https://www.mdpi.com/2077-0383/10/17/4001 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 17, p 4001 |
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Journal of Clinical Medicine |
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Francesco Giuseppe Foschi Alberto Borghi Alberto Grassi Arianna Lanzi Elvira Speranza Teo Vignoli Lucia Napoli Deanna Olivoni Michele Sanza Edoardo Polidori Giovanni Greco Paolo Bassi Francesco Cristini Giorgio Ballardini Mattia Altini Fabio Conti on behalf of MITH Group |
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Elektronische Aufsätze |
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Francesco Giuseppe Foschi |
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10.3390/jcm10174001 |
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title_sort |
model of care for microelimination of hepatitis c virus infection among people who inject drugs |
title_auth |
Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs |
abstract |
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. |
abstractGer |
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. |
abstract_unstemmed |
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; <i<p</i< = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; <i<p</i< = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection. |
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container_issue |
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Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs |
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https://doi.org/10.3390/jcm10174001 https://doaj.org/article/55bd77bea46245eba572df0630fab999 https://www.mdpi.com/2077-0383/10/17/4001 https://doaj.org/toc/2077-0383 |
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Alberto Borghi Alberto Grassi Arianna Lanzi Elvira Speranza Teo Vignoli Lucia Napoli Deanna Olivoni Michele Sanza Edoardo Polidori Giovanni Greco Paolo Bassi Francesco Cristini Giorgio Ballardini Mattia Altini Fabio Conti on behalf of MITH Group |
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Alberto Borghi Alberto Grassi Arianna Lanzi Elvira Speranza Teo Vignoli Lucia Napoli Deanna Olivoni Michele Sanza Edoardo Polidori Giovanni Greco Paolo Bassi Francesco Cristini Giorgio Ballardini Mattia Altini Fabio Conti on behalf of MITH Group |
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up_date |
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