Search

Background: The introduction of Direct-Acting Antivirals (DAAs) transformed Hepatitis C (HCV) treatment, despite this uptake of DAAs remains lower than required to meet the WHO Sustainable Development Goal (3.3). Treatment with interferon was suggested to be able to deliver important outcomes for people who use drugs in addition to a viral cure, such as social redemption, and shift from a stigmatised identity. There is a lack of understanding if DAAs can deliver these transformative outcomes. Methods: This recurrent cross-sectional study combines qualitative semi-structured interviews and demographic data of 15 participants receiving DAAs in Tayside, Scotland. A thematic analysis explored the non-clinical outcomes of DAA treatment viewed through the lens of the Social Identity Model of Recovery (SIMOR) to build understanding of the influence DAAs have in a recovery journey from drug use. Results: Three key themes emerged: identity, relationships and social networks; building recovery capital; and reflecting on re-infection and the shift to DAAs. Concern about the transmission of HCV resulted in self-imposed isolation which weakened support structures. Cure provides a mechanism to strengthen family bonds, however social networks in the wider community remain limited. Participants gained opportunities to undertake activities that build health and wellbeing providing a shift in identity, future plans and aspirations. Social isolation remained for some, revealing unmet need in post-cure support. Conclusion: DAAs may support recovery journeys through the SIMOR, individuals reduced the number of active users within their social network and reconnected with family members, building recovery capital. Individuals, however, remained socially isolated in the context of the wider community. HCV services should support links to community resources to deliver the social inclusion people desire. [ABSTRACT FROM AUTHOR]

Purpose: Hepatitis C virus (HCV) is a small, enveloped, single stranded RNA virus of Flaviviridae family. HCV causes both acute and chronic infection. Diagnosis of HCV can be done by indirect serological tests that detect antibodies against HCV (anti-HCV) and direct test that detects and quantifies components of viral RNA particles. As per CDC recommendation; HCV testing should be initiated with anti-HCV test, those anti-HCV positive/ reactive should have follow-up testing with Nucleic Acid Test. If the HCV RNA is detected, patient should be directed for the treatment with highly effective direct acting antiviral (DAA). This study aims to determine the seroprevalence of HCV infection, to estimate presumptive HCV infection by using serological assay by anti-HCV ELISA, to estimate the current HCV infection by detecting HCV-RNA using RT-PCR molecular assay and, to highlight the role of HCV RNA for initiation of treatment. Methods: This study is retrospective observational analysis of 36500 samples obtained for anti-HCV ELISA test from Jan to Dec 2022. The ELISA kit used was a 3rd generation sandwich assay. All ELISA positive samples were tested for HCV RNA, by automated qRT-PCR method. Results: Out of 36500 samples, 361 tested positive by anti-HCV ELISA with 0.9% seroprevalence. Out of 361, only 336 were tested for HCV RNA. Of 336, 240 samples were negative as target not detected, and 96 samples showed values as viral copies in IU/mL. Most common age group affected was 18-40 years, for both serology and molecular test. Conclusion: In current study, only 96 samples showed viral copies indicating current HCV infection and need to start treatment. Hepatitis C is curable; with the availability of highly effective DAA both in a brand and generic form can cure > 95% of infected people, so the possibility of achieving the target of elimination HCV by 2030 can be predicted. [ABSTRACT FROM AUTHOR]