Evaluation of the hepatitis C cascade of care among people living with HIV in New South Wales, Australia: A data linkage study. Issue 4 (25th February 2022)

• Record Type: Journal Article
• Authors: Hosseini‐Hooshyar, Samira; Alavi, Maryam; Martinello, Marianne; Valerio, Heather; Tillakeratne, Shane; Matthews, Gail V.; Dore, Gregory J.
• Is Part Of: Journal of viral hepatitis. Volume 29:Issue 4(2022)
• Page Start: 271
• Page End: 279
• Publication Date: 2022-02-25
• Subjects: care cascade -- direct‐acting antivirals -- HCV -- HCV RNA testing -- people living with HIV; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.13658
• Languages: English
• ISSNs: 1352-0504

Abstract

Abstract: People living with HIV (PLHIV) are a priority population to receive hepatitis C virus (HCV) screening and treatment. We aimed to characterize the HCV care cascade among PLHIV between 2010 and 2018 and to compare HCV testing and treatment uptake pre‐ and post‐availability of direct‐acting antivirals (DAAs) in New South Wales (NSW), Australia. Records of all HCV notifications (1993–2017) were linked to HIV notifications, deaths, hospitalizations, incarcerations, opioid agonist therapy, HCV RNA testing and treatment databases. Numbers and proportions were calculated for all stages of the care cascade and factors associated with HCV testing, and DAA treatment uptake were evaluated using logistic regression. From 383 individuals with HCV notification (2009–2017), 349 (91%) were ever HCV RNA tested, 285 (74%) had an indicator of chronic HCV infection, and from those eligible for treatment, 210 (74%) received HCV treatment. HCV testing was recorded for 85% pre‐DAA era and reached a cumulative proportion of 90% post‐DAA while treatment uptake had a 10‐fold increase from 7% pre‐ to 73% post‐DAA era. Younger age (adjusted odds ratio [aOR] 0.98; 95% CI 0.96–0.99), female gender (aOR 1.87; 95% CI 1.10–3.19), and rural region residence at notification (aOR 1.56; 95% CI 1.03–2.36) were associated with not receiving HCV testing. No identified factor was associated with not receiving treatment post‐DAA era. Removing barriers to HCV testing, expanding treatment to a variety of settings and continuous education and harm reduction are essential to achieve HCV elimination among PLHIV in Australia.