澳大利亚维多利亚州 2012 年至 2020 年阿片类激动剂治疗接受者的丙型肝炎抗体检测。

Hepatitis C antibody testing among opioid agonist therapy recipients, Victoria, Australia, 2012 to 2020.

机构信息

Burnet Institute, Melbourne, Australia.

Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

出版信息

Int J Drug Policy. 2022 Jun;104:103696. doi: 10.1016/j.drugpo.2022.103696. Epub 2022 Apr 28.

DOI:10.1016/j.drugpo.2022.103696

PMID:35490624

Abstract

BACKGROUND

The high burden of hepatitis C among people who inject drugs in Australia underscores the need to increase testing within this population. Understanding hepatitis C screening uptake in primary care settings is therefore critical to the development of effective and targeted strategies to improve hepatitis C testing for people who inject drugs. Primary care services that prescribe OAT are well-positioned to provide hepatitis C testing among a priority population at-risk of hepatitis C.

METHODS

This study used linked data from 5,429 individuals attending ten clinical services participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) who received their first recorded OAT prescription between 1 January 2012 and 31 December 2019. We estimated the proportion of OAT recipients who received a hepatitis C antibody test within 12 months of their first recorded OAT prescription, and the proportion of individuals tested who received a positive hepatitis C antibody test.

RESULTS

Approximately one in five individuals (17%) received a hepatitis C antibody test in the 12 months following their first recorded OAT prescription. Over half of individuals tested (56%) received a positive hepatitis C antibody test result. Hepatitis C antibody testing was higher among individuals who attended 5-8 (aOR:2.98; 95%CI:2.41-3.69) and 9+ (aOR:6.17; 95%CI:5.13-7.43) clinical consultations, were women (aOR:1.20; 95%CI:1.08-1.34) and whose first recorded OAT prescription occurred in 2017 vs. 2012 (aOR:1.39; 95%CI:1.06-1.84). Hepatitis C antibody testing was lower among individuals prescribed methadone (aOR:0.81; 95%CI:0.73-0.91), and individuals aged 60+ years vs. 18-29 years (aOR:0.67; 95%CI:0.48-0.94).

CONCLUSION

Despite high positivity rates, hepatitis C antibody testing among individuals prescribed OAT remains low. There are opportunities for increased testing among populations exhibiting greater proportions of missed testing opportunities. Integrating routine hepatitis C screening in OAT settings will likely increase case-finding and contribute to Australia's hepatitis C elimination targets.

摘要

背景

在澳大利亚，注射毒品者中丙型肝炎负担沉重，这突显了需要增加该人群的检测。因此，了解初级保健环境中的丙型肝炎筛查参与情况对于制定有效的、有针对性的策略以改善注射毒品者的丙型肝炎检测至关重要。开处 OAT 的初级保健服务有很好的条件，可以在丙型肝炎高危的重点人群中提供丙型肝炎检测。

方法

本研究使用了参加澳大利亚协调强化监测（ACCESS）的十个临床服务的 5429 名个体的链接数据，这些个体在 2012 年 1 月 1 日至 2019 年 12 月 31 日期间首次接受记录 OAT 处方。我们估计了在首次记录的 OAT 处方后 12 个月内接受丙型肝炎抗体检测的 OAT 接受者的比例，以及接受检测的个体中丙型肝炎抗体检测呈阳性的比例。

结果

大约五分之一的个体（17%）在首次记录的 OAT 处方后 12 个月内接受了丙型肝炎抗体检测。接受检测的个体中，超过一半（56%）的丙型肝炎抗体检测呈阳性。在接受 5-8（优势比：2.98；95%置信区间：2.41-3.69）和 9+（优势比：6.17；95%置信区间：5.13-7.43）次临床就诊的个体、女性（优势比：1.20；95%置信区间：1.08-1.34）以及首次记录的 OAT 处方发生在 2017 年而非 2012 年的个体（优势比：1.39；95%置信区间：1.06-1.84）中，丙型肝炎抗体检测的比例更高。接受美沙酮处方（优势比：0.81；95%置信区间：0.73-0.91）和 60 岁以上（优势比：0.67；95%置信区间：0.48-0.94）个体的丙型肝炎抗体检测比例较低。