Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis

Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Hernandez-Con, Pilar [verfasserIn] Wilson, Debbie L. [verfasserIn] Tang, Huilin [verfasserIn] Unigwe, Ikenna [verfasserIn] Riaz, Munaza [verfasserIn] Ourhaan, Natalie [verfasserIn] Jiang, Xinyi [verfasserIn] Song, Hyun Jin [verfasserIn] Joseph, Amanda [verfasserIn] Henry, Linda [verfasserIn] Cook, Robert [verfasserIn] Jayaweera, Dushyantha [verfasserIn] Park, Haesuk [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Übergeordnetes Werk:	Enthalten in: American journal of preventive medicine - Amsterdam [u.a.] : Elsevier Science, 1985, 65, Seite 1153-1162
Übergeordnetes Werk:	volume:65 ; pages:1153-1162

DOI / URN:	10.1016/j.amepre.2023.06.016

Katalog-ID:	ELV065663977

Internformat


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100	1		\|a Hernandez-Con, Pilar \|e verfasserin \|0 (orcid)0000-0003-4959-9141 \|4 aut
245	1	0	\|a Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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520			\|a Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations).
700	1		\|a Wilson, Debbie L. \|e verfasserin \|4 aut
700	1		\|a Tang, Huilin \|e verfasserin \|4 aut
700	1		\|a Unigwe, Ikenna \|e verfasserin \|4 aut
700	1		\|a Riaz, Munaza \|e verfasserin \|4 aut
700	1		\|a Ourhaan, Natalie \|e verfasserin \|4 aut
700	1		\|a Jiang, Xinyi \|e verfasserin \|0 (orcid)0000-0002-9097-2641 \|4 aut
700	1		\|a Song, Hyun Jin \|e verfasserin \|4 aut
700	1		\|a Joseph, Amanda \|e verfasserin \|4 aut
700	1		\|a Henry, Linda \|e verfasserin \|4 aut
700	1		\|a Cook, Robert \|e verfasserin \|0 (orcid)0000-0002-7770-3754 \|4 aut
700	1		\|a Jayaweera, Dushyantha \|e verfasserin \|0 (orcid)0000-0002-4142-2002 \|4 aut
700	1		\|a Park, Haesuk \|e verfasserin \|0 (orcid)0000-0003-3299-8111 \|4 aut
773	0	8	\|i Enthalten in \|t American journal of preventive medicine \|d Amsterdam [u.a.] : Elsevier Science, 1985 \|g 65, Seite 1153-1162 \|h Online-Ressource \|w (DE-627)320601552 \|w (DE-600)2020236-2 \|w (DE-576)255692846 \|x 1873-2607 \|7 nnns
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912			\|a GBV_ILN_62
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912			\|a GBV_ILN_69
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912			\|a GBV_ILN_73
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912			\|a GBV_ILN_90
912			\|a GBV_ILN_100
912			\|a GBV_ILN_101
912			\|a GBV_ILN_105
912			\|a GBV_ILN_110
912			\|a GBV_ILN_151
912			\|a GBV_ILN_187
912			\|a GBV_ILN_213
912			\|a GBV_ILN_224
912			\|a GBV_ILN_230
912			\|a GBV_ILN_370
912			\|a GBV_ILN_602
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912			\|a GBV_ILN_2056
912			\|a GBV_ILN_2059
912			\|a GBV_ILN_2061
912			\|a GBV_ILN_2064
912			\|a GBV_ILN_2088
912			\|a GBV_ILN_2106
912			\|a GBV_ILN_2110
912			\|a GBV_ILN_2111
912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2122
912			\|a GBV_ILN_2129
912			\|a GBV_ILN_2143
912			\|a GBV_ILN_2152
912			\|a GBV_ILN_2153
912			\|a GBV_ILN_2190
912			\|a GBV_ILN_2232
912			\|a GBV_ILN_2336
912			\|a GBV_ILN_2470
912			\|a GBV_ILN_2507
912			\|a GBV_ILN_4035
912			\|a GBV_ILN_4037
912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4242
912			\|a GBV_ILN_4249
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allfields	10.1016/j.amepre.2023.06.016 doi (DE-627)ELV065663977 (ELSEVIER)S0749-3797(23)00278-7 DE-627 ger DE-627 rda eng 610 VZ 44.11 bkl Hernandez-Con, Pilar verfasserin (orcid)0000-0003-4959-9141 aut Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Wilson, Debbie L. verfasserin aut Tang, Huilin verfasserin aut Unigwe, Ikenna verfasserin aut Riaz, Munaza verfasserin aut Ourhaan, Natalie verfasserin aut Jiang, Xinyi verfasserin (orcid)0000-0002-9097-2641 aut Song, Hyun Jin verfasserin aut Joseph, Amanda verfasserin aut Henry, Linda verfasserin aut Cook, Robert verfasserin (orcid)0000-0002-7770-3754 aut Jayaweera, Dushyantha verfasserin (orcid)0000-0002-4142-2002 aut Park, Haesuk verfasserin (orcid)0000-0003-3299-8111 aut Enthalten in American journal of preventive medicine Amsterdam [u.a.] : Elsevier Science, 1985 65, Seite 1153-1162 Online-Ressource (DE-627)320601552 (DE-600)2020236-2 (DE-576)255692846 1873-2607 nnns volume:65 pages:1153-1162 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 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_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.11 Präventivmedizin VZ AR 65 1153-1162
spelling	10.1016/j.amepre.2023.06.016 doi (DE-627)ELV065663977 (ELSEVIER)S0749-3797(23)00278-7 DE-627 ger DE-627 rda eng 610 VZ 44.11 bkl Hernandez-Con, Pilar verfasserin (orcid)0000-0003-4959-9141 aut Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Wilson, Debbie L. verfasserin aut Tang, Huilin verfasserin aut Unigwe, Ikenna verfasserin aut Riaz, Munaza verfasserin aut Ourhaan, Natalie verfasserin aut Jiang, Xinyi verfasserin (orcid)0000-0002-9097-2641 aut Song, Hyun Jin verfasserin aut Joseph, Amanda verfasserin aut Henry, Linda verfasserin aut Cook, Robert verfasserin (orcid)0000-0002-7770-3754 aut Jayaweera, Dushyantha verfasserin (orcid)0000-0002-4142-2002 aut Park, Haesuk verfasserin (orcid)0000-0003-3299-8111 aut Enthalten in American journal of preventive medicine Amsterdam [u.a.] : Elsevier Science, 1985 65, Seite 1153-1162 Online-Ressource (DE-627)320601552 (DE-600)2020236-2 (DE-576)255692846 1873-2607 nnns volume:65 pages:1153-1162 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 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_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.11 Präventivmedizin VZ AR 65 1153-1162
allfields_unstemmed	10.1016/j.amepre.2023.06.016 doi (DE-627)ELV065663977 (ELSEVIER)S0749-3797(23)00278-7 DE-627 ger DE-627 rda eng 610 VZ 44.11 bkl Hernandez-Con, Pilar verfasserin (orcid)0000-0003-4959-9141 aut Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Wilson, Debbie L. verfasserin aut Tang, Huilin verfasserin aut Unigwe, Ikenna verfasserin aut Riaz, Munaza verfasserin aut Ourhaan, Natalie verfasserin aut Jiang, Xinyi verfasserin (orcid)0000-0002-9097-2641 aut Song, Hyun Jin verfasserin aut Joseph, Amanda verfasserin aut Henry, Linda verfasserin aut Cook, Robert verfasserin (orcid)0000-0002-7770-3754 aut Jayaweera, Dushyantha verfasserin (orcid)0000-0002-4142-2002 aut Park, Haesuk verfasserin (orcid)0000-0003-3299-8111 aut Enthalten in American journal of preventive medicine Amsterdam [u.a.] : Elsevier Science, 1985 65, Seite 1153-1162 Online-Ressource (DE-627)320601552 (DE-600)2020236-2 (DE-576)255692846 1873-2607 nnns volume:65 pages:1153-1162 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 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_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.11 Präventivmedizin VZ AR 65 1153-1162
allfieldsGer	10.1016/j.amepre.2023.06.016 doi (DE-627)ELV065663977 (ELSEVIER)S0749-3797(23)00278-7 DE-627 ger DE-627 rda eng 610 VZ 44.11 bkl Hernandez-Con, Pilar verfasserin (orcid)0000-0003-4959-9141 aut Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Wilson, Debbie L. verfasserin aut Tang, Huilin verfasserin aut Unigwe, Ikenna verfasserin aut Riaz, Munaza verfasserin aut Ourhaan, Natalie verfasserin aut Jiang, Xinyi verfasserin (orcid)0000-0002-9097-2641 aut Song, Hyun Jin verfasserin aut Joseph, Amanda verfasserin aut Henry, Linda verfasserin aut Cook, Robert verfasserin (orcid)0000-0002-7770-3754 aut Jayaweera, Dushyantha verfasserin (orcid)0000-0002-4142-2002 aut Park, Haesuk verfasserin (orcid)0000-0003-3299-8111 aut Enthalten in American journal of preventive medicine Amsterdam [u.a.] : Elsevier Science, 1985 65, Seite 1153-1162 Online-Ressource (DE-627)320601552 (DE-600)2020236-2 (DE-576)255692846 1873-2607 nnns volume:65 pages:1153-1162 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 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_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.11 Präventivmedizin VZ AR 65 1153-1162
allfieldsSound	10.1016/j.amepre.2023.06.016 doi (DE-627)ELV065663977 (ELSEVIER)S0749-3797(23)00278-7 DE-627 ger DE-627 rda eng 610 VZ 44.11 bkl Hernandez-Con, Pilar verfasserin (orcid)0000-0003-4959-9141 aut Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations). Wilson, Debbie L. verfasserin aut Tang, Huilin verfasserin aut Unigwe, Ikenna verfasserin aut Riaz, Munaza verfasserin aut Ourhaan, Natalie verfasserin aut Jiang, Xinyi verfasserin (orcid)0000-0002-9097-2641 aut Song, Hyun Jin verfasserin aut Joseph, Amanda verfasserin aut Henry, Linda verfasserin aut Cook, Robert verfasserin (orcid)0000-0002-7770-3754 aut Jayaweera, Dushyantha verfasserin (orcid)0000-0002-4142-2002 aut Park, Haesuk verfasserin (orcid)0000-0003-3299-8111 aut Enthalten in American journal of preventive medicine Amsterdam [u.a.] : Elsevier Science, 1985 65, Seite 1153-1162 Online-Ressource (DE-627)320601552 (DE-600)2020236-2 (DE-576)255692846 1873-2607 nnns volume:65 pages:1153-1162 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 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_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.11 Präventivmedizin VZ AR 65 1153-1162
language	English
source	Enthalten in American journal of preventive medicine 65, Seite 1153-1162 volume:65 pages:1153-1162
sourceStr	Enthalten in American journal of preventive medicine 65, Seite 1153-1162 volume:65 pages:1153-1162
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container_title	American journal of preventive medicine
authorswithroles_txt_mv	Hernandez-Con, Pilar @@aut@@ Wilson, Debbie L. @@aut@@ Tang, Huilin @@aut@@ Unigwe, Ikenna @@aut@@ Riaz, Munaza @@aut@@ Ourhaan, Natalie @@aut@@ Jiang, Xinyi @@aut@@ Song, Hyun Jin @@aut@@ Joseph, Amanda @@aut@@ Henry, Linda @@aut@@ Cook, Robert @@aut@@ Jayaweera, Dushyantha @@aut@@ Park, Haesuk @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
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fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">ELV065663977</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20231118093258.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">231118s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.amepre.2023.06.016</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV065663977</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0749-3797(23)00278-7</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.11</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Hernandez-Con, Pilar</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0003-4959-9141</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. 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author	Hernandez-Con, Pilar
spellingShingle	Hernandez-Con, Pilar ddc 610 bkl 44.11 Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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topic_title	610 VZ 44.11 bkl Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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title	Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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title_full	Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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author_browse	Hernandez-Con, Pilar Wilson, Debbie L. Tang, Huilin Unigwe, Ikenna Riaz, Munaza Ourhaan, Natalie Jiang, Xinyi Song, Hyun Jin Joseph, Amanda Henry, Linda Cook, Robert Jayaweera, Dushyantha Park, Haesuk
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title_sort	hepatitis c cascade of care in the direct-acting antivirals era: a meta-analysis
title_auth	Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
abstract	Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations).
abstractGer	Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations).
abstract_unstemmed	Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. Public health interventions targeting identified priority areas (e.g., emergency departments) may improve screening and healthcare retention of vulnerable populations with HCV infection (e.g., substance use disorder populations).
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title_short	Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis
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author2	Wilson, Debbie L. Tang, Huilin Unigwe, Ikenna Riaz, Munaza Ourhaan, Natalie Jiang, Xinyi Song, Hyun Jin Joseph, Amanda Henry, Linda Cook, Robert Jayaweera, Dushyantha Park, Haesuk
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up_date	2024-07-06T23:49:09.317Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">ELV065663977</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20231118093258.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">231118s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.amepre.2023.06.016</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV065663977</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0749-3797(23)00278-7</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.11</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Hernandez-Con, Pilar</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0003-4959-9141</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: The hepatitis C virus (HCV) epidemic remains a public health problem worldwide. A systematic review and meta-analysis were conducted to provide evidence of outcomes attained across the HCV care cascade in the era of direct-acting antivirals.Methods: Studies from North America, Europe, and Australia (January 2014 through March 2021) reporting on HCV care cascade outcomes (screening to cure) were included. When calculating the proportions of individuals completing each step, the numerator for Steps 1–8 was the number of individuals completing each step; the denominator was the number of individuals completing the previous step for Steps 1–3 and Step 3 for Steps 4–8. In 2022, random effects meta-analyses were conducted to estimate pooled proportions with 95% CIs.Results: Sixty-five studies comprising 7,402,185 individuals were identified. Among individuals with positive HCV ribonucleic acid test results, 62% (95% CI=55%, 70%) attended their first care appointment, 41% (95% CI=37%, 45%) initiated treatment, 38% (95% CI=29%, 48%) completed treatment, and 29% (95% CI=25%, 33%) achieved cure. HCV screening rates were 43% (95% CI=22%, 66%) in prisons or jails and 20% (95% CI=11%, 31%) in emergency departments. Linkage to care rates were 62% (95% CI=46%, 75%) for homeless individuals and 26% (95% CI=22%, 31%) for individuals diagnosed in emergency departments. Cure rates were 51% (95% CI=30%, 73%) in individuals with substance use disorder and 17% (95% CI=17%, 17%) in homeless individuals. Cure rates were lowest in the U.S.Discussion: Despite the availability of effective all-oral direct-acting antiviral therapies, persistent gaps remain across the HCV care cascade, especially among traditionally marginalized populations. 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Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis

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