The Kirby Institute, University of New South Wales, Sydney, Australia.
Infectious Disease Implementation Science Group, Burnet Institute, Melbourne, Australia.
Drug Alcohol Rev. 2023 Nov;42(7):1617-1632. doi: 10.1111/dar.13723. Epub 2023 Aug 9.
Evaluating progress towards hepatitis C virus (HCV) elimination among Aboriginal and Torres Strait Islander peoples is critical given the disproportionate burden of infection. We examined factors associated with current HCV infection and self-reported treatment among Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal peoples) and non-Aboriginal peoples who inject drugs (PWID) in Australia.
ETHOS Engage is an observational cohort study of PWID attending drug treatment and needle and syringe programs in Australia. Participants underwent point-of-care HCV RNA testing (Xpert HCV RNA Viral Load Fingerstick) and completed a questionnaire including self-reported history of HCV treatment.
Between May 2018 and June 2021, 2395 participants were enrolled and 555 (23%) identified as Aboriginal (median age 42 years, 58% were men, 63% injected drugs in last month, 76% ever incarcerated). HCV RNA prevalence was 23% among Aboriginal PWID (24% in 2018-2019 and 21% in 2019-2021; p = 0.44), and 21% among non-Aboriginal PWID (24% in 2018-2019 and 16% in 2019-2021; p < 0.001). Self-reported HCV treatment was 65% among Aboriginal PWID (63% in 2018-2019 and 69% in 2019-2021; p = 0.30), and 70% among non-Aboriginal PWID (67% in 2018-2019 and 75% in 2019-2021; p < 0.001). Among Aboriginal PWID, current HCV infection was associated with recently injecting drugs and receiving opioid agonist treatment, and self-reported HCV treatment was negatively associated with younger age, homelessness and recently injecting drugs.
Equitable access to HCV care and prevention is needed to ensure Australia meets its elimination targets among Aboriginal PWID.
鉴于感染负担不成比例，评估澳大利亚原住民和托雷斯海峡岛民（以下简称原住民）中丙型肝炎病毒（HCV）消除进展至关重要。我们研究了澳大利亚注射吸毒者（PWID）中与当前 HCV 感染和自我报告的 HCV 治疗相关的因素，包括原住民和非原住民。
ETHOS Engage 是一项观察性队列研究，纳入了澳大利亚接受药物治疗和针具交换项目的 PWID。参与者接受了即时 HCV RNA 检测（Xpert HCV RNA 病毒载量指尖采血），并完成了一份包括自我报告 HCV 治疗史的问卷。
2018 年 5 月至 2021 年 6 月，共纳入 2395 名参与者，其中 555 名（23%）为原住民（中位年龄 42 岁，58%为男性，63%在过去一个月内注射毒品，76%曾被监禁）。原住民 PWID 的 HCV RNA 流行率为 23%（2018-2019 年为 24%，2019-2021 年为 21%；p=0.44），而非原住民 PWID 的 HCV RNA 流行率为 21%（2018-2019 年为 24%，2019-2021 年为 16%；p<0.001）。原住民 PWID 中自我报告的 HCV 治疗率为 65%（2018-2019 年为 63%，2019-2021 年为 69%；p=0.30），而非原住民 PWID 中自我报告的 HCV 治疗率为 70%（2018-2019 年为 67%，2019-2021 年为 75%；p<0.001）。在原住民 PWID 中，当前 HCV 感染与最近注射毒品和接受阿片类激动剂治疗有关，而自我报告的 HCV 治疗与年龄较小、无家可归和最近注射毒品有关。
需要公平获得 HCV 护理和预防，以确保澳大利亚实现其在原住民 PWID 中的消除目标。
