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

Meghan D Morris; Ali Mirzazadeh; Jennifer L Evans; Alya Briceno; Phillip Coffin; Judith A Hahn; Kimberly A Page

doi:10.1016/j.drugalcdep.2019.02.008

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

Drug Alcohol Depend. 2019 May 1:198:133-135. doi: 10.1016/j.drugalcdep.2019.02.008. Epub 2019 Feb 27.

Authors

Meghan D Morris¹, Ali Mirzazadeh², Jennifer L Evans³, Alya Briceno³, Phillip Coffin⁴, Judith A Hahn⁵, Kimberly A Page⁶

Affiliations

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: [email protected].
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.

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.

Keywords: HCV treatment; Hepatitis C virus (HCV); Injection drug use.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Antiviral Agents / therapeutic use*
Drug Users / psychology
Drug Users / statistics & numerical data*
Female
Hepacivirus*
Hepatitis C / drug therapy*
Hepatitis C / psychology
Hepatitis C / virology
Humans
Male
Prospective Studies
San Francisco
Substance Abuse, Intravenous / psychology
Substance Abuse, Intravenous / virology*
Surveys and Questionnaires
Sustained Virologic Response
Young Adult

Substances

Antiviral Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding