Association between rapid utilisation of direct hepatitis C antivirals and decline in the prevalence of viremia among people who inject drugs in Australia
Association between rapid utilisation of direct hepatitis C antivirals and decline in the prevalence of viremia among people who inject drugs in Australia
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DOI：
10.1016/j.jhep.2018.09.030
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发表时间：
2019-01-01
影响因子：
25.7
通讯作者：
Maher, Lisa
中科院分区：
文献类型：
--
作者：
Iversen, Jenny;Dore, Gregory J.;Maher, Lisa
背景和目标：世界卫生组织（WHO）制定了到2030年消除丙型肝炎病毒（HCV）感染这一公共卫生威胁的目标。HCV治疗可以降低注射毒品（PWID）人群中病毒血症患病率的证据有限。自2016年3月以来，澳大利亚直接作用抗病毒（DAA）治疗的广泛可及性为评估这些治疗在真实世界setting.Methods人群水平上的疗效提供了机会：来自澳大利亚年度生物行为监测的数据检查了2015年至2017年期间全国参加针头注射器项目的PWID患者的治疗吸收和估计病毒血症患病率。2017年，多变量logistic回归分析确定了与HCV治疗独立相关的变量，这些变量被认为是合格的（抗HCV阳性，不包括HCV RNA阴性，没有自我报告的HCV治疗史）。抗-HCV患病率从57%（2015年）下降至49%（2017年，卡方检验（2）p趋势= 50岁校正比值比[aOR] 1.82; 95% CI 1.09-3.06; p = 0.023; 44-49岁aOR 1.75; 95% CI 1.03-3.00; p = 0.038 vs.
Background & Aims: The World Health Organization (WHO) established targets to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030. Evidence that HCV treatment can lower viraemic prevalence among people who inject drugs (PWID) is limited. Broad accessibility of direct-acting antiviral (DAA) therapy in Australia, since March 2016, provides an opportunity to assess the efficacy of these treatments at a population level in a real-world setting.Methods: Data from Australia's annual bio-behavioural surveillance examined treatment uptake and estimated viraemic prevalence among PWID attending needle syringe programs nationally between 2015 and 2017. Multivariate logistic regression identified variables independently associated with HCV treatment among those considered eligible (anti-HCV positive excluding HCV RNA negative with no self-reported history of HCV treatment) in 2017.Results: Annual samples ranged from 1,995-2,380 PWID. Anti-HCV prevalence declined from 57% (2015) to 49% (2017, chi(2) p trend = 50 years adjusted odds ratio [aOR] 1.82; 95% CI 1.09-3.06; p = 0.023 and 44-49 years aOR 1.75; 95% CI 1.03-3.00; p = 0.038 vs.