Cargando…

Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study

Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-t...

Descripción completa

Detalles Bibliográficos
Autores principales: Granozzi, Bianca, Guardigni, Viola, Badia, Lorenzo, Rosselli Del Turco, Elena, Zuppiroli, Alberto, Tazza, Beatrice, Malosso, Pietro, Pieralli, Stefano, Viale, Pierluigi, Verucchi, Gabriella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584608/
https://www.ncbi.nlm.nih.gov/pubmed/34768474
http://dx.doi.org/10.3390/jcm10214955
_version_ 1784597490514788352
author Granozzi, Bianca
Guardigni, Viola
Badia, Lorenzo
Rosselli Del Turco, Elena
Zuppiroli, Alberto
Tazza, Beatrice
Malosso, Pietro
Pieralli, Stefano
Viale, Pierluigi
Verucchi, Gabriella
author_facet Granozzi, Bianca
Guardigni, Viola
Badia, Lorenzo
Rosselli Del Turco, Elena
Zuppiroli, Alberto
Tazza, Beatrice
Malosso, Pietro
Pieralli, Stefano
Viale, Pierluigi
Verucchi, Gabriella
author_sort Granozzi, Bianca
collection PubMed
description Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-treat patients when managed for HCV in hospital or in an out-of-hospital setting. Methods. In our retrospective study, we categorized the included patients (PWID and homeless persons) into two groups according to whether anti-HCV treatment was offered and provided in a hospital or an out-of-hospital setting. We run logistic regressions to evaluate factors associated with retention in care (defined as the completion of direct antiviral agents (DAAs) therapy). Results. We included 56 patients in our study: 27 were in the out-of-hospital group. Overall, 33 patients completed DAAs therapy. A higher rate of retention in care was observed in the out-of-hospital group rather than in-hospital group (p = 0.001). At the univariate analysis, retention in care was associated with the out-of-hospital management (p = 0.002) and with a shorter time between the first visit and the scheduled start of DAAs (p = 0.003). Conclusions. The choice of treatment models that can better adapt to difficult-to-treat populations, such as an out-of-hospital approach, will be important for achieving the eradication of HCV infection.
format Online
Article
Text
id pubmed-8584608
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85846082021-11-12 Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study Granozzi, Bianca Guardigni, Viola Badia, Lorenzo Rosselli Del Turco, Elena Zuppiroli, Alberto Tazza, Beatrice Malosso, Pietro Pieralli, Stefano Viale, Pierluigi Verucchi, Gabriella J Clin Med Article Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-treat patients when managed for HCV in hospital or in an out-of-hospital setting. Methods. In our retrospective study, we categorized the included patients (PWID and homeless persons) into two groups according to whether anti-HCV treatment was offered and provided in a hospital or an out-of-hospital setting. We run logistic regressions to evaluate factors associated with retention in care (defined as the completion of direct antiviral agents (DAAs) therapy). Results. We included 56 patients in our study: 27 were in the out-of-hospital group. Overall, 33 patients completed DAAs therapy. A higher rate of retention in care was observed in the out-of-hospital group rather than in-hospital group (p = 0.001). At the univariate analysis, retention in care was associated with the out-of-hospital management (p = 0.002) and with a shorter time between the first visit and the scheduled start of DAAs (p = 0.003). Conclusions. The choice of treatment models that can better adapt to difficult-to-treat populations, such as an out-of-hospital approach, will be important for achieving the eradication of HCV infection. MDPI 2021-10-26 /pmc/articles/PMC8584608/ /pubmed/34768474 http://dx.doi.org/10.3390/jcm10214955 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Granozzi, Bianca
Guardigni, Viola
Badia, Lorenzo
Rosselli Del Turco, Elena
Zuppiroli, Alberto
Tazza, Beatrice
Malosso, Pietro
Pieralli, Stefano
Viale, Pierluigi
Verucchi, Gabriella
Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_full Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_fullStr Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_full_unstemmed Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_short Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_sort out-of-hospital treatment of hepatitis c increases retention in care among people who inject drugs and homeless persons: an observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584608/
https://www.ncbi.nlm.nih.gov/pubmed/34768474
http://dx.doi.org/10.3390/jcm10214955
work_keys_str_mv AT granozzibianca outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT guardigniviola outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT badialorenzo outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT rossellidelturcoelena outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT zuppirolialberto outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT tazzabeatrice outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT malossopietro outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT pierallistefano outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT vialepierluigi outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy
AT verucchigabriella outofhospitaltreatmentofhepatitiscincreasesretentionincareamongpeoplewhoinjectdrugsandhomelesspersonsanobservationalstudy