Valerio Heather, Conway Anna, Alavi Maryam, Treloar Carla, Silk David, Murray Carolyn, Henderson Charles, Amin Janaki, Read Phillip, Degenhardt Louisa, Christmass Michael, Montebello Mark, Dore Gregory J, Grebely Jason
The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia.
Int J Drug Policy. 2022 Dec;110:103876. doi: 10.1016/j.drugpo.2022.103876. Epub 2022 Oct 12.
Awareness of hepatitis C virus (HCV) infection status among people who inject drugs (PWID) can empower people with diagnosis, enable treatment uptake, and facilitate elimination. We aimed to evaluate awareness of HCV infection status among a large national cohort of PWID in an era of unrestricted HCV treatment.
ETHOS Engage is an observational cohort study of PWID attending drug treatment clinics and needle and syringe programs in Australia. Participants completed a questionnaire containing self-reported HCV data (including infection status: never tested, tested/unknown, no current HCV infection [HCV RNA not detectable], current HCV infection [HCV RNA detectable]) and underwent point-of-care HCV RNA testing (Xpert® HCV Viral Load Fingerstick). Awareness was defined as concordant self-reported HCV status and test result. Awareness was assessed among all participants, those with current HCV infection, and participants who reported a lifetime history of HCV treatment. Logistic regression was used to assess factors associated with awareness in these three populations.
Among 2,305 PWID, 65% (n=1,506) were aware of their HCV infection status (self-reported HCV status matched HCV point-of-care result). Awareness of infection status was higher among those who were not currently infected (70%, n=1,281/1,818) compared to those with current HCV infection (46%, n=225/487). After adjusting, those with current HCV infection were less likely to be aware of infection status (aOR: 0.40, 95%CI: 0.30, 0.45). Among those who reported a lifetime history of HCV treatment, 71% (n=592/829) were aware of their HCV infection status.
Among a large cohort of PWID in Australia, awareness of HCV infection status is sub-optimal, with particularly concerning levels among those with active infection. Increased and simplified testing, post-test counselling, and post-treatment monitoring is warranted.
注射吸毒者（PWID）对丙型肝炎病毒（HCV）感染状况的知晓，可使确诊者获得力量、促进治疗接受并推动消除该疾病。我们旨在评估在HCV治疗不受限制的时代，一大群全国性PWID队列中对HCV感染状况的知晓情况。
ETHOS Engage是一项针对在澳大利亚戒毒治疗诊所及针头和注射器项目就诊的PWID的观察性队列研究。参与者完成了一份包含自我报告的HCV数据（包括感染状况：从未检测、检测过/结果未知、目前无HCV感染[HCV RNA检测不到]、目前有HCV感染[HCV RNA可检测到]）的问卷，并接受即时检验HCV RNA检测（Xpert® HCV病毒载量指尖检测）。知晓被定义为自我报告的HCV状况与检测结果一致。在所有参与者、目前有HCV感染的参与者以及报告有HCV治疗终生史的参与者中评估知晓情况。使用逻辑回归评估这三个人群中与知晓相关的因素。
在2305名PWID中，65%（n = 1506）知晓其HCV感染状况（自我报告的HCV状况与HCV即时检验结果相符）。与目前有HCV感染的人（46%，n = 225/487）相比，目前未感染的人对感染状况的知晓率更高（70%，n = 1281/1818）。调整后，目前有HCV感染的人知晓感染状况的可能性较小（调整后比值比：0.40，95%置信区间：0.30，0.45）。在报告有HCV治疗终生史的人中，71%（n = 592/829）知晓其HCV感染状况。
在澳大利亚一大群PWID中，对HCV感染状况的知晓情况不理想，尤其是在有活动性感染的人群中，其知晓水平令人担忧。有必要增加并简化检测、检测后咨询以及治疗后监测。
