Integrating HCV Services

Expansion of HCV treatment access to people who have injected drugs through effective translation of research into public health policy: Scotland’s experience;
S.J. Hutchinson et al. / International Journal of Drug Policy (2015)

The Action Plan has demonstrated that a Government-backed, coordinated and invested approach can transform services and rapidly improve the lives of thousands. Cited as ‘‘an impressive example of a national strategy’’ by the Global Commission on Drug Policy, the Scottish Plan has also provided fundamental insights of international relevance into the management of HCV among PWID.

Integrating HCV services for drug users: A model to improve engagement and outcomes;
D.L. Sylvestre, J.E. Zweben; International Journal of Drug Policy 18 (2007) 406–410

Integrating services for hepatitis C, addiction, mental health, and psychosocial problems, the model involves a collaboration of medical providers and peer educators and incorporates elements of other proven behavioural models, including self-help groups, therapeutic communities, and peer interventions. Our results indicate that this peer-based model is successful at engaging, educating, and treating a diverse spectrum of chaotic drug users. We conclude that an integrated, peer-based approach to intervention can engage even the most challenging addicted patients with hepatitis C, and can facilitate their successful screening and treatment.

The leadership of communities in HIV service delivery
Barr et al. AIDS 2015, Vol 29 (Suppl 2)

This article describes integrated approaches to service delivery in which affected communities play a key role in the development and implementation of HIV programmes. Further scale-up of these approaches to care can improve overall quality, reduce stigma and discrimination, increase demand for services and improve retention in care.

Barriers and Facilitators of Hepatitis C Screening among People Who Inject Drugs:
A Multi-City, Mixed-Methods Study, Joshua A Barocas et al. Harm Reduction Journal 2014, 11:1 doi:10.1186/1477-7517-11-1

Our results suggest that drug-injecting individuals who reside in non-urban settings, who have poor access to primary care, or who have less education may encounter significant barriers to routine HCV screening. Expanded access to primary health care and prevention services, especially in non-urban areas, could address an unmet need for individuals at high risk for HCV.

Combination Interventions to Prevent HCV Transmission Among People Who Inject Drugs:
Modeling the Impact of Antiviral Treatment, Needle and Syringe Programs, and Opiate Substitution Therapy, Natasha K. Martin, et al., Clinical Infectious Diseases 2013;57(S2):S39–45

Combining antiviral treatment with OST with high-coverage needle and syringe programs (HCNSP) is critical for achieving substantial reductions (>50%) in HCV chronic prevalence over 10 years. Empirical studies are required on how best to scale up antiviral treatment and combine treatment with other interventions.

Evaluating a Hepatitis C Quality Gap: Missed Opportunities for HCV-Related Care,
Yang Liu, MD; Renee H. Lawrence, PhD; Yngve Falck-Ytter, MD; Brook Watts, MD; and Amy A. Hirsch, PharmD, The American Journal of Managed Care 2014

With more widespread testing anticipated and more effective treatments available, health systems should ensure the HCV diagnostic process results in the delivery of an accurate and timely HCV diagnosis, to reduce the risk of harm to patients.

Georgia Launches Programme to Curb Hepatitis,
Manana Vardiashvili, Institute for War & Peace Reporting 2014 http://iwpr.net

Under a nationwide programme which Georgiaʼs government has launched to tackle hepatitis C, 10,000 people will become eligible for subsidised medicines, and treatment will be free in the prison system, where the disease is common.

Increasing Hepatitis C Treatment Uptake among HIV-Infected Patients Using an HIV Primary Care Model,
Edward R Cachay et al, AIDS Research and Therapy 2013, 10:9 doi:10.1186/1742-6405-10-9

Access to Hepatitis C (HCV) care is low among HIV-infected individuals, highlighting the need for new models to deliver care for this population. Using a HIV primary care model increased the number of HIV patients who initiate HCV therapy with comparable outcomes to a hepatology model.

Integrating Multiple Programme and Policy Approaches to Hepatitis C Prevention and Care for Injection Drug Users:
A Comprehensive Approach, Birkhead GS et al, International Journal of Drug Policy 2007

A comprehensive, public health approach, using multiple strategies across systems and mobilizing multiple sectors, can enhance IDUs access to HCV prevention and care. A holisitic approach with integrated services, including for HCV-HIV co-infected IDUs is needed. Leadership, collaboration and resources are essential.

Taming Systems to Create Enabling Environments for HCV Treatment:
NegotiatingTrust in the Drug and Alcohol Setting, Magdalena Harris et al, Social Science & Medicine 83 (2013) 19e26

The study aimed to assess the accessibility and quality of HCV treatment provision for PWID located at D&A services in London, United Kingdom. We explore how providers of HCV treatment conceptualise and employ ‘trust’ in their efforts to engage PWID in HCV treatment and care. Drawing upon qualitative research nested inside two London based HCV treatment partnerships with drug and alcohol services, we explore how certain assemblages within the environments of hospital-based and D&A service-based treatment settings interact to foster stigmatisation and mistrust.

Interagency Implementation Progress Report for the Action Plan for the Prevention, Care & Treatment of Viral Hepatitis,
US Department of Health and Human Services, 2013

This second progress report features select highlights of progress made in implementing the Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis during 2012. Compiled by the HHS Office of HIV/AIDS and Infectious Disease Policy (OHAIDP), the report spotlights several key accomplishments under each of the Action Plan’s six priority areas.