The hepatitis C care cascade among people who inject drugs accessing harm reduction services in Catalonia: Major gaps for migrants
Por:
Folch, C, Saludes, V, Reyes-Urena, J, Antuori, A, Ibanez, N, Majo, X, Colom, J, Matas, L, Casabona, J and Martro, E
Publicada:
1 abr 2021
Ahead of Print:
11 dic 2020
Resumen:
Background: This study aimed to describe the HCV cascade of care among people who inject drugs (PWID) in Catalonia, as well as to compare the observed gaps in care between Spanish-born and migrant PWID.
Methods: A cross-sectional study of PWID (N = 410) attending four harm reduction services (HRS) was performed in 2016-17 (HepC detect II Study). Participants were tested for both HCV antibodies (rapid testing) and RNA (from dried blood spot samples). The HCV care cascade was estimated from HCV testing results combined with self-reported data on previous testing, diagnosis and treatment collected through a questionnaire. Logistic regressions were used to test for an association between migration status and the proportions observed in each step of the HCV care cascade adjusting for age, sex, years of injection, homelessness, and treatment for drug dependence.
Results: Overall, 85.4% were men and 28.0% were migrants. Among Spanish-born (n = 295) and migrant (n = 115) PWID participants in the study, 96.6% vs. 88.6% had previously been HCV screened (AOR=3.11; 95% CI: 1.11-8.65), 79.3% vs. 80.9% were antibody positive, and 70.7% vs. 67.6% were HCV-RNA positive or cured with treatment; among the latter, 36.6% vs. 18.2% had started treatment (AOR=2.41; 95% CI: 1.09-5.34), and 20.6% vs. 9.1% had been cured by treatment, respectively. Unawareness of having hepatitis C was more common among migrants than Spanish-born PWID (46.0% and 31.5%, respectively; p<0.05).
Conclusion: This study estimates the HCV care cascade among Spanish-born and migrant PWID in Catalonia for the very first time, and highlights a higher attrition of migrant PWID in all HCV care cascade stages. The observed limited linkage to care and treatment by PWID that attend the HRS network warrants future implementation of decentralized diagnosis and antiviral treatment. Strategies focusing on migrants by increasing HCV screening coverage and treatment access will be especially relevant in our setting.
Filiaciones:
:
Catalonia Publ Hlth Agcy ASPCAT, Ctr Epidemiol Studies Sexually Transmitted Infect, Badalona, Spain
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
:
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
Hosp Univ Germans Trios Pujol, Inst Invest Germans Trios & Pujol IGTP, Microbiol Dept, Lab Clin Metropolitana Nord, Badalona, Spain
Univ Autonoma Barcelona, Genet & Microbiol Dept, Bellaterra, Spain
:
Catalonia Publ Hlth Agcy ASPCAT, Ctr Epidemiol Studies Sexually Transmitted Infect, Badalona, Spain
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
:
Hosp Univ Germans Trios Pujol, Inst Invest Germans Trios & Pujol IGTP, Microbiol Dept, Lab Clin Metropolitana Nord, Badalona, Spain
Univ Autonoma Barcelona, Genet & Microbiol Dept, Bellaterra, Spain
Ibanez, N:
ASPCAT, Programme Prevent Control & Treatment HIV STIs &, Badalona, Spain
Majo, X:
ASPCAT, Programme Prevent Control & Treatment HIV STIs &, Badalona, Spain
Colom, J:
ASPCAT, Programme Prevent Control & Treatment HIV STIs &, Badalona, Spain
:
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
Hosp Univ Germans Trios Pujol, Inst Invest Germans Trios & Pujol IGTP, Microbiol Dept, Lab Clin Metropolitana Nord, Badalona, Spain
Univ Autonoma Barcelona, Genet & Microbiol Dept, Bellaterra, Spain
:
Catalonia Publ Hlth Agcy ASPCAT, Ctr Epidemiol Studies Sexually Transmitted Infect, Badalona, Spain
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
:
Inst Salud Carlos III, Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Grp 27, Madrid, Spain
Hosp Univ Germans Trios Pujol, Inst Invest Germans Trios & Pujol IGTP, Microbiol Dept, Lab Clin Metropolitana Nord, Badalona, Spain
Univ Autonoma Barcelona, Genet & Microbiol Dept, Bellaterra, Spain
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