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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.