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Progress toward closing gaps in the hepatitis C virus cascade of care for people who inject drugs in San Francisco

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  • Ali Mirzazadeh
  • Yea-Hung Chen
  • Jess Lin
  • Katie Burk
  • Erin C Wilson
  • Desmond Miller
  • Danielle Veloso
  • Willi McFarland
  • Meghan D Morris

Abstract

Background: People who inject drugs (PWID) are disproportionately affected by hepatitis C virus (HCV). Data tracking the engagement of PWID in the continuum of HCV care are needed to assess the reach, target the response, and gauge impact of HCV elimination efforts. Methods: We analyzed data from the National HIV Behavioral Surveillance (NHBS) surveys of PWID recruited via respondent driven sampling (RDS) in San Francisco in 2018. We calculated the number and proportion who self-reported ever: (1) tested for HCV, (2) tested positive for HCV antibody, (3) diagnosed with HCV, (4) received HCV treatment, (5) and attained sustained viral response (SVR). To assess temporal changes, we compared 2018 estimates to those from the 2015 NHBS sample. Results: Of 456 PWID interviewed in 2018, 88% had previously been tested for HCV, 63% tested antibody positive, and 50% were diagnosed with HCV infection. Of those diagnosed, 42% received treatment. Eighty-one percent of those who received treatment attained SVR. In 2015 a similar proportion of PWID were tested and received an HCV diagnosis, compared to 2018. However, HCV treatment was more prevalent in the 2018 sample (19% vs. 42%, P-value 0.01). Adjusted analysis of 2018 survey data showed having no health insurance (APR 1.6, P-value 0.01) and having no usual source of health care (APR 1.5, P-value 0.01) were significantly associated with untreated HCV prevalence. Conclusion: While findings indicate an improvement in HCV treatment uptake among PWID in San Francisco, more than half of PWID diagnosed with HCV infection had not received HCV treatment in 2018. Policies and interventions to increase coverage are necessary, particularly among PWID who are uninsured and outside of regular care.

Suggested Citation

  • Ali Mirzazadeh & Yea-Hung Chen & Jess Lin & Katie Burk & Erin C Wilson & Desmond Miller & Danielle Veloso & Willi McFarland & Meghan D Morris, 2021. "Progress toward closing gaps in the hepatitis C virus cascade of care for people who inject drugs in San Francisco," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-11, April.
    • Handle: RePEc:plo:pone00:0249585
    DOI: 10.1371/journal.pone.0249585
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    References listed on IDEAS

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    1. Gile, Krista J., 2011. "Improved Inference for Respondent-Driven Sampling Data With Application to HIV Prevalence Estimation," Journal of the American Statistical Association, American Statistical Association, vol. 106(493), pages 135-146.
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