Table 4 Treatment outcomes (7 studies)
From: Hepatitis C virus infection in Irish drug users and prisoners – a scoping review
Date and author | Setting | Sample (n) | Data collection | Design | Main results | |
|---|---|---|---|---|---|---|
[50] | 2005 Keating et al | Dublin Multi-site 5 drug treatment centres | PWID mono-infected with HCV (496; m = 341; 2 years follow up = 127) | Jan 1997- Nov 2001 Repeat follow up testing in 2003 | Cross-sectional prospective study on HCV clearance | HCV RNA: • Negative = 38% (self-clearance) (f = 47.4%; m = 34.5%) • Follow up (2 yrs) = 82.2% sustained viral clearance • Overall viral clearance = 31.1% • Genotype distribution (1 = 48.8%; 3 = 48.5%) |
[76] | 2006 Hopkins | Single site Hospital | Co-infected with HIV and HCV patients with CD4 counts > 200 cells/mL (45; m = 39; PWID = 58%) | June 2001–2003 | Open-label, prospective study | SVR = 53% • Genotype 2 and 3 patients had a significantly higher SVR (75%) than genotype 1 (19%) • Adverse events occurred frequently |
[74] | 2011 Kieran et al | Dublin Single-site Hospital Integrated HIV/HCV clinic | Co-infected attendees (386; m = 278) | October 2008–January 2009 | Retrospective chart review | 202/386 – referred to co-infected clinic, with 107 completing treatment • SVR = 44% (similar outcomes for PWID compared to patients with other transmission risks) Associations with missed appointments • younger age • active IDU • advanced HIV infection Dedicated co-infection clinics lower the threshold for treatment and improve management of liver disease in co-infected patients |
[75] | 2011 Lowry et al | Dublin Single-site Hospital | HCV mono-infected patients referred (588 individuals (repeat referrals = 742 cases); m = 388; PWID = 74%) | 2000–2007 | Retrospective chart review | SVR = 74% • History of IDU was not a significant predictor of lower therapy completion rate or achievement of SVR In total, 451 (61%) dropouts occurred • 141 (19%) failed to attend their initial appointment • 180 dropped out from early outpatient management • 29 failed to attend liver biopsy • 81 defected from subsequent outpatient follow-up. Statistically significant associations with history of injection drug use • dropout immediately after the referral (P < 0.001) • dropout from early outpatient management (P < 0.001) • dropout over entire span of disease management (P < 0.001) Male sex was also associated with dropout from disease management (P < 0.05) |
[52] | 2012 Kelly and Kelly | Dublin Single site GP | PWID (82; m = 62%) | 1985–2010 | Longitudinal cohort study | Anti-HCV = 33% at 10 yrs. (survivors) Anti-HCV = 40% at 25 yrs. (survivors) • 63% of the cohort had died by 2010, of which 26 were attributed to HIV disease • Median survival time for those ant-HCV = 21 years (95% CI 15.5–26.5) which was significantly lower than the median survival time for drug users with a negative hepatitis C status. (p = 0.006) |
[77] | 2017 Elsherif et al | Dublin Single-site Hospital | HCV infected patients (1000; Former PWID (> 6 months) = 608; Recent PWID (< 6 months) = 85; Non-drug users = 307) | 2002–2012 | Retrospective chart review | SVR in PWID = 64.2% • No significant compared to non-PWID (60.9%) [RR = 1.05, 95% CI 0.95 ± 1.17] • There was no significant difference in SVR rates between the groups controlling for genotype (48.4% vs 48.4% for genotype 1; 74.9 vs 73.3% for genotype 3). • No significant difference in treatment non-adherence between the groups (8.4% in PWID vs 6.8% in non-PWIDs; RR = 1.23, CI 0.76 ± 1.99) • Former and recent PWID had similar adherence rates. |