Care Facilitation Advances Movement Along the Hepatitis C Care Continuum for Persons With Human Immunodeficiency Virus, Hepatitis C, and Substance Use: A Randomized Clinical Trial (CTN-0064).

Autor: Metsch LR; Department of Sociomedical Sciences, Columbia University, New York, New York, USA., Feaster DJ; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Gooden LK; Department of Sociomedical Sciences, Columbia University, New York, New York, USA., Masson C; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA., Perlman DC; Division of Infectious Diseases, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Jain MK; Division of Infectious Diseases, University of Texas Southwestern Medical Center and Parkland Health & Hospital System, Dallas, Texas, USA., Matheson T; Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, California, USA., Nelson CM; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Jacobs P; Center for Clinical Trials Network, National Institute on Drug Abuse, Rockville, Maryland, USA., Tross S; Department of Psychiatry, Columbia University, New York, New York, USA., Haynes L; College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA., Lucas GM; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Colasanti JA; Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA., Rodriguez A; Infectious Disease, University of Miami, Miami, Florida, USA., Drainoni ML; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA., Osorio G; Division of Infectious Diseases, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Nijhawan AE; Division of Infectious Diseases, University of Texas Southwestern Medical Center and Parkland Health & Hospital System, Dallas, Texas, USA., Jacobson JM; Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, Ohio, USA., Sullivan M; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA., Metzger D; HIV/AIDS Prevention Research Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Vergara-Rodriguez P; Mental Health and Substance Abuse Division, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois, USA., Lubelchek R; Infectious Diseases, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois, USA., Duan R; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Batycki JN; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Matthews AG; Data Statistical Center, The Emmes Company, LLC, Rockville, Maryland, USA., Munoz F; Data Statistical Center, The Emmes Company, LLC, Rockville, Maryland, USA., Jelstrom E; Clinical Coordinating Center, The Emmes Company, LLC, Rockville, Maryland, USA., Mandler R; Clinical/Medical Branch, National Institute on Drug Abuse, Rockville, Maryland, USA., Del Rio C; Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2021 Jun 27; Vol. 8 (8), pp. ofab334. Date of Electronic Publication: 2021 Jun 27 (Print Publication: 2021).
DOI: 10.1093/ofid/ofab334
Abstrakt: Background: Direct-acting antivirals can cure hepatitis C virus (HCV). Persons with HCV/HIV and living with substance use are disadvantaged in benefiting from advances in HCV treatment.
Methods: In this randomized controlled trial, participants with HCV/HIV were randomized between February 2016 and January 2017 to either care facilitation or control. Twelve-month follow-up assessments were completed in January 2018.Care facilitation group participants received motivation and strengths-based case management addressing retrieval of HCV viral load results, engagement in HCV/HIV care, and medication adherence. Control group participants received referral to HCV evaluation and an offer of assistance in making care appointments. Primary outcome was number of steps achieved along a series of 8 clinical steps (eg, receiving HCV results, initiating treatment, sustained virologic response [SVR]) of the HCV/HIV care continuum over 12 months postrandomization.
Results: Three hundred eighty-one individuals were screened and 113 randomized. Median age was 51 years; 58.4% of participants were male and 72.6% were Black/African American. Median HIV-1 viral load was 27 209 copies/mL, with 69% having a detectable viral load. Mean number of steps completed was statistically significantly higher in the intervention group vs controls (2.44 vs 1.68 steps; χ  2 [1] = 7.36, P  = .0067). Men in the intervention group completed a statistically significantly higher number of steps than controls. Eleven participants achieved SVR with no difference by treatment group.
Conclusions: The care facilitation intervention increased progress along the HCV/HIV care continuum, as observed for men and not women. Study findings also highlight continued challenges to achieve individual-patient SVR and population-level HCV elimination.
Clinical Trials Registration: NCT02641158.
(© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje