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Potential interventions to support HCV treatment uptake among HIV co-infected people in Canada: Perceptions of patients and health care providers - PubMed

  • ️Sat Jan 01 2022

Potential interventions to support HCV treatment uptake among HIV co-infected people in Canada: Perceptions of patients and health care providers

David Ortiz-Paredes et al. Can Liver J. 2022.

Abstract

Background: Increasing direct-acting antiviral (DAA) treatment uptake is key to eliminating HCV infection as a public health threat in Canada. People living with human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection face barriers to HCV treatment initiation. We sought to identify interventions that could support HCV treatment initiation based on patient and HCV care provider perspectives.

Methods: Eleven people living with HIV with a history of HCV infection and 12 HCV care providers were recruited for this qualitative descriptive study. Participants created ranked-ordered lists of potential interventions during nominal groups (n = 4) and individual interviews (n = 6). Following the nominal group technique, transcripts and intervention lists underwent thematic analysis and ranking scores were merged to create consolidated and prioritized lists from patient and provider perspectives.

Results: Patient participants identified a total of eight interventions. The highest-ranked interventions were multidisciplinary clinics, HCV awareness campaigns and patient education, nurse- or pharmacist-led care, peer involvement, and more and better-prepared health professionals. Provider participants identified 11 interventions. The highest-ranked were mobile outreach, DAA initiation at pharmacies, a simplified process of DAA prescription, integration of primary and specialist care, and patient-centred approaches.

Conclusion: Participants proposed alternatives to hospital-based specialist HCV care, which require increasing capacity for nurses, pharmacists, primary care providers, and peers to have more direct roles in HCV treatment provision. They also identified the need for structural changes and educational initiatives. In addition to optimizing HCV care, these interventions might result in broader benefits for the health of HIV-HCV co-infected people.

Keywords: HIV infection; Indigenous peoples; direct-acting antivirals; hepatitis C; men who have sex with men; people who inject drugs; treatment uptake; women.

Copyright © 2022 Canadian Association for the Study of the Liver.

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Conflict of interest statement

B Lebouché reports grants for investigator-initiated studies from ViiV Healthcare, Merck, and Gilead, and consulting fees from ViiV Healthcare, Merck, and Gilead. He is the holder of a Canadian Institutes for Health Research, Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials for HIV Care and supported by a career award, LE 250, from Québec’s Ministry of Health for researchers in Family Medicine. MB Klein reports grants from Gilead during the conduct of the study; grants from ViiV Healthcare, grants from Merck, and grants from AbbVie, outside the submitted work. The other authors have nothing to disclose.

Figures

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Figure 1:

Interventions to improve HCV treatment uptake HCV = Hepatitis C virus; DAA = Direct-acting antiviral

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Grants and funding

This investigator-initiated study was supported by funding through the Gilead Sciences LEGA-C Program (grant number IN-US-334-4492, June 1, 2018).

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