부산대학교 도서관

Background: Chronic hepatitis C virus (HCV) infection is highly prevalent among people who inject drugs but is often undiagnosed. The treatment paradigm for HCV patients has been changing since the availability of direct‐acting antiviral (DAA) treatment. We aimed to evaluate the change in treatment paradigm of people who previously injected drugs (ex‐PWID) in Hong Kong before and after the availability of DAA. Method: Consecutive ex‐PWID referred from various nongovernmental organizations attended education talks at rehabilitation centers and received point‐of‐care rapid test for HCV antibody (anti‐HCV) at the same session. Subjects tested positive for anti‐HCV were invited to undergo further assessment. Afterwards, the patients were referred to the regional hospitals for follow‐up and/or treatment. Results: Three hundred sixty‐five ex‐PWID received HCV rapid test; 268 (73.4%) were found to be anti‐HCV positive. Among these 268 HCV‐positive ex‐PWID, 234 (87.3%) attended the assessment session (mean age 52 years, 90.2% male, 45.5% genotype 1b, 41.1% genotype 6a, and median liver stiffness 5.9 kPa); 187 (69.8%) attended follow‐up visits at regional hospitals. Seventy‐one patients received antiviral treatment for HCV; 69 first received peginterferon and ribavirin (PegIFN/RBV), whereas 10 patients (eight PegIFN/RBV‐treated patients) received DAA treatment. Fifty‐two patients achieved sustained virologic response at 12 or 24 weeks. Treatment uptake rates of PegIFN/RBV and DAA treatment in the pre‐DAA versus post‐DAA era were 22.3% versus 48.5% and 0% versus 15.6%, respectively. Conclusions: Targeted screening in ex‐PWID is effective in identifying patients with HCV infection in the community. To improve treatment uptake, further improvements in the referral system and treatment regimens are needed. [ABSTRACT FROM AUTHOR]