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Hepatitis C treatment uptake and adherence among injecting drug users in the Czech Republic.
Epidemiol Mikrobiol Imunol ; 63(4): 265-9, 2014 Nov.
Article en En | MEDLINE | ID: mdl-25523218
BACKGROUND: Injecting drug users (IDUs) represent a major subpopulation of hepatitis C virus (HCV)-infected people in developed countries. Yet their uptake to treatment is generally low despite well-documented effectiveness of HCV treatment among former and active IDUs. The present study represents the first attempt to describe the HCV treatment coverage among IDUs and identify factors that affect treatment uptake in the Czech Republic. METHODS: From January to March 2011, a questionnaire survey was conducted among viral hepatitis treatment centres in the Czech Republic. RESULTS: From a total of 76 identified hepatitis treatment centres existing in the country, 39 provided HCV treatment to (mainly former or abstaining) IDUs in 2010. Most clinicians reported being cautious in initiating HCV treatment in IDUs. Abstinence, a screening phase before treatment initiation, opioid substitution treatment and an external evaluation by a specialist were often prerequisites for skrting treatment. However, HCV treatment centres rarely provided drug-use specific services. Financial constraints were also reported, further limiting the inclusion of IDUs into treatment, as non-users are widely preferred to active drug users. Clinicians reported no difference in treatment uptake and adherence between drug users and non-users, nor between opioid and methamphetamine users. CONCLUSION: A number of system- and provider-related factors limit HCV treatment in IDUs in the Czech Republic, despite permissive national clinical guidelines. Targeting these factors is crucial to reduce HCV prevalence at population level.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Abuso de Sustancias por Vía Intravenosa / Cooperación del Paciente / Hepatitis C Tipo de estudio: Etiology_studies / Guideline / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Epidemiol Mikrobiol Imunol Asunto de la revista: ALERGIA E IMUNOLOGIA / EPIDEMIOLOGIA / MICROBIOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: República Checa
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Abuso de Sustancias por Vía Intravenosa / Cooperación del Paciente / Hepatitis C Tipo de estudio: Etiology_studies / Guideline / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Epidemiol Mikrobiol Imunol Asunto de la revista: ALERGIA E IMUNOLOGIA / EPIDEMIOLOGIA / MICROBIOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: República Checa