Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up
BACKGROUND: First Nations Peoples of Australia are disproportionally affected by hepatitis C (HCV) infection. Through a prospective study we evaluated the outcome of direct-acting antiviral (DAA) therapy among First Nations Peoples with HCV infection. METHODS: Adults who initiated DAA therapy at one...
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BioMed Central
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275019/ http://www.ncbi.nlm.nih.gov/pubmed/35820850 https://doi.org/10.1186/s12876-022-02416-5 |
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Research Clark, Paul J. Valery, Patricia C. Ward, James Strasser, Simone I. Weltman, Martin Thompson, Alexander Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Angus, Peter George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William Macquillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Chu, Geoff Harding, Damian Cheng, Wendy Farrell, Geoff Roberts, Stuart K. Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
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Research |
description |
BACKGROUND: First Nations Peoples of Australia are disproportionally affected by hepatitis C (HCV) infection. Through a prospective study we evaluated the outcome of direct-acting antiviral (DAA) therapy among First Nations Peoples with HCV infection. METHODS: Adults who initiated DAA therapy at one of 26 hospitals across Australia, 2016–2019 were included in the study. Clinical data were obtained from medical records and the Pharmaceutical and Medicare Benefits Schemes. Outcomes included sustained virologic response (SVR) and loss to follow-up (LTFU). A multivariable analysis assessed factors associated with LTFU. RESULTS: Compared to non-Indigenous Australians (n = 3206), First Nations Peoples (n = 89) were younger (p < 0.001), morel likely to reside in most disadvantaged (p = 0.002) and in regional/remote areas (p < 0.001), and had similar liver disease severity. Medicines for mental health conditions were most commonly dispensed among First Nations Peoples (55.2% vs. 42.8%; p = 0.022). Of 2910 patients with follow-up data, both groups had high SVR rates (95.3% of First Nations Peoples vs. 93.2% of non-Indigenous patients; p = 0.51) and ‘good’ adherence (90.0% vs. 86.9%, respectively; p = 0.43). However, 28.1% of First Nations Peoples were LTFU vs. 11.2% of non-Indigenous patients (p < 0.001). Among First Nations Peoples, younger age (adj-OR = 0.93, 95% CI 0.87–0.99) and treatment initiation in 2018–2019 vs. 2016 (adj-OR = 5.14, 95% CI 1.23–21.36) predicted LTFU, while higher fibrosis score was associated with better engagement in HCV care (adj-OR = 0.71, 95% CI 0.50–0.99). CONCLUSIONS: Our data showed that First Nations Peoples have an equivalent HCV cure rate, but higher rates of LTFU. Better strategies to increase engagement of First Nations Peoples with HCV care are needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02416-5. |
format |
Text |
author |
Clark, Paul J. Valery, Patricia C. Ward, James Strasser, Simone I. Weltman, Martin Thompson, Alexander Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Angus, Peter George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William Macquillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Chu, Geoff Harding, Damian Cheng, Wendy Farrell, Geoff Roberts, Stuart K. |
author_facet |
Clark, Paul J. Valery, Patricia C. Ward, James Strasser, Simone I. Weltman, Martin Thompson, Alexander Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Angus, Peter George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William Macquillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Chu, Geoff Harding, Damian Cheng, Wendy Farrell, Geoff Roberts, Stuart K. |
author_sort |
Clark, Paul J. |
title |
Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
title_short |
Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
title_full |
Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
title_fullStr |
Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
title_full_unstemmed |
Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up |
title_sort |
hepatitis c treatment outcomes for australian first nations peoples: equivalent svr rate but higher rates of loss to follow-up |
publisher |
BioMed Central |
publishDate |
2022 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275019/ http://www.ncbi.nlm.nih.gov/pubmed/35820850 https://doi.org/10.1186/s12876-022-02416-5 |
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First Nations |
genre_facet |
First Nations |
op_source |
BMC Gastroenterol |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275019/ http://www.ncbi.nlm.nih.gov/pubmed/35820850 http://dx.doi.org/10.1186/s12876-022-02416-5 |
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© The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
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CC0 PDM CC-BY |
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https://doi.org/10.1186/s12876-022-02416-5 |
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BMC Gastroenterology |
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22 |
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ftpubmed:oai:pubmedcentral.nih.gov:9275019 2023-05-15T16:14:02+02:00 Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up Clark, Paul J. Valery, Patricia C. Ward, James Strasser, Simone I. Weltman, Martin Thompson, Alexander Levy, Miriam T. Leggett, Barbara Zekry, Amany Rong, Julian Angus, Peter George, Jacob Bollipo, Steven McGarity, Bruce Sievert, William Macquillan, Gerry Tse, Edmund Nicoll, Amanda Wade, Amanda Chu, Geoff Harding, Damian Cheng, Wendy Farrell, Geoff Roberts, Stuart K. 2022-07-11 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275019/ http://www.ncbi.nlm.nih.gov/pubmed/35820850 https://doi.org/10.1186/s12876-022-02416-5 en eng BioMed Central http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275019/ http://www.ncbi.nlm.nih.gov/pubmed/35820850 http://dx.doi.org/10.1186/s12876-022-02416-5 © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. CC0 PDM CC-BY BMC Gastroenterol Research Text 2022 ftpubmed https://doi.org/10.1186/s12876-022-02416-5 2022-07-31T01:15:09Z BACKGROUND: First Nations Peoples of Australia are disproportionally affected by hepatitis C (HCV) infection. Through a prospective study we evaluated the outcome of direct-acting antiviral (DAA) therapy among First Nations Peoples with HCV infection. METHODS: Adults who initiated DAA therapy at one of 26 hospitals across Australia, 2016–2019 were included in the study. Clinical data were obtained from medical records and the Pharmaceutical and Medicare Benefits Schemes. Outcomes included sustained virologic response (SVR) and loss to follow-up (LTFU). A multivariable analysis assessed factors associated with LTFU. RESULTS: Compared to non-Indigenous Australians (n = 3206), First Nations Peoples (n = 89) were younger (p < 0.001), morel likely to reside in most disadvantaged (p = 0.002) and in regional/remote areas (p < 0.001), and had similar liver disease severity. Medicines for mental health conditions were most commonly dispensed among First Nations Peoples (55.2% vs. 42.8%; p = 0.022). Of 2910 patients with follow-up data, both groups had high SVR rates (95.3% of First Nations Peoples vs. 93.2% of non-Indigenous patients; p = 0.51) and ‘good’ adherence (90.0% vs. 86.9%, respectively; p = 0.43). However, 28.1% of First Nations Peoples were LTFU vs. 11.2% of non-Indigenous patients (p < 0.001). Among First Nations Peoples, younger age (adj-OR = 0.93, 95% CI 0.87–0.99) and treatment initiation in 2018–2019 vs. 2016 (adj-OR = 5.14, 95% CI 1.23–21.36) predicted LTFU, while higher fibrosis score was associated with better engagement in HCV care (adj-OR = 0.71, 95% CI 0.50–0.99). CONCLUSIONS: Our data showed that First Nations Peoples have an equivalent HCV cure rate, but higher rates of LTFU. Better strategies to increase engagement of First Nations Peoples with HCV care are needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02416-5. Text First Nations PubMed Central (PMC) BMC Gastroenterology 22 1 |