Management of hepatitis C virus (HCV) infection in drug substitution programs.

Détails

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Etat: Serval
Version: Final published version
ID Serval
serval:BIB_45FF0A0FEC48
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Management of hepatitis C virus (HCV) infection in drug substitution programs.
Périodique
Swiss medical weekly
Auteur(s)
Witteck A., Schmid P., Hensel-Koch K., Thurnheer M.C., Bruggmann P., Vernazza P.
Collaborateur(s)
Swiss Hepatitis C and HIV Cohort Studies
Contributeur(s)
Negro F., Hadengue A., Kaiser L., Rubbia-Brandt L., Moradpour D., Burgisser P., Francioli P., Estoppey-Younes S., Schoni-Affolter F., Rickenbach M., Martinetti G., Cerny A., Masserey Spicher V., Gorgievski M., Dufour J., Hirsch H., Heim H., Helbling B., Müllhaupt B., Regenass S., Malinverni R., Meyenberger C., Borovicka J., Dollenmaier G., Cathomas G., Battegay M., Bernasconi E., Böni J., Bucher H., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Fux C., Gorgievski M., Günthard H., Hirsch H., Hirschel B., Hösli I., Kahlert C., Kaiser L., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Müller N., Nadal D., Paccaud F., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schöni-Affolter F., Schüpbach J., Speck R., de Tejada B., Taffé P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
27/05/2011
Peer-reviewed
Oui
Volume
141
Pages
w13193
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
In Switzerland, intravenous drug use (IDU) accounts for 80% of newly acquired hepatitis C virus (HCV) infections. Early HCV treatment has the potential to interrupt the transmission chain and reduce morbidity/mortality due to decompensated liver cirrhosis and hepatocellular carcinoma. Nevertheless, patients in drug substitution programs are often insufficiently screened and treated.
With the aim to improve HCV management in IDUs, we conducted a cross sectional chart review in three opioid substitution programs in St. Gallen (125 methadone and 71 heroin recipients). Results were compared with another heroin substitution program in Bern (202 patients) and SCCS/SHCS data.
Among the methadone/heroin recipients in St. Gallen, diagnostic workup of HCV was better than expected: HCV/HIV-status was unknown in only 1% (2/196), HCV RNA was not performed in 9% (13/146) of anti-HCV-positives and the genotype missing in 15% (12/78) of HCV RNA-positives. In those without spontaneous clearance (two thirds), HCV treatment uptake was 23% (21/91) (HIV-: 29% (20/68), HIV+: 4% (1/23)), which was lower than in methadone/heroin recipients and particularly non-IDUs within the SCCS/SHCS, but higher than in the, mainly psychiatrically focussed, heroin substitution program in Bern (8%). Sustained virological response (SVR) rates were comparable in all settings (overall: 50%, genotype 1: 35-40%, genotype 3: two thirds). In St. Gallen, the median delay from the estimated date of infection (IDU start) to first diagnosis was 10 years and to treatment was another 7.5 years.
Future efforts need to focus on earlier HCV diagnosis and improvement of treatment uptake among patients in drug substitution programs, particularly if patients are HIV-co-infected. New potent drugs might facilitate the decision to initiate treatment.

Mots-clé
Adult, Antiviral Agents/therapeutic use, Cross-Sectional Studies, Delayed Diagnosis/statistics & numerical data, Female, Genotype, HIV Infections/complications, Hepacivirus/genetics, Hepatitis C/complications, Hepatitis C/diagnosis, Hepatitis C/drug therapy, Hepatitis C/virology, Humans, Male, Middle Aged, Patient Compliance/statistics & numerical data, RNA, Viral/blood, Retrospective Studies, Substance Abuse Treatment Centers/statistics & numerical data, Substance-Related Disorders/complications, Switzerland, Time Factors, Young Adult
Pubmed
Web of science
Open Access
Oui
Création de la notice
19/01/2012 15:15
Dernière modification de la notice
08/05/2019 17:55
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