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Viral Hepatitis and Human Immunodeficiency Virus Testing and Linkage to Care for Individuals Enrolled in an Opioid Treatment Program.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2020 Sep 02; Vol. 222 (Suppl 5), pp. S384-S391. - Publication Year :
- 2020
-
Abstract
- Background: In the United States, many opioid treatment programs (OTPs) do not offer viral hepatitis (VH) or human immunodeficiency virus (HIV) testing despite high prevalence among OTP clients. We initiated an opt-out VH and HIV testing and linkage-to-care program within our OTP.<br />Methods: All OTP intakes are screened for VH and HIV and evaluated for rescreening annually. A patient navigator reviews laboratory results and provides counseling in the OTP clinic. The medical record is queried to identify individuals with previously diagnosed, untreated VH or HIV. Navigation support is provided for linkage or relinkage to VH or HIV care.<br />Results: Between March 2018 and Februrary 2019, 532 individuals were screened for hepatitis C virus (HCV), 180 tested HCV antibody positive (34%), and 108 were HCV-ribonucleic acid (RNA) positive (20%). Sixty individuals were identified with previously diagnosed, untreated HCV. Of all HCV RNA+, 49% reported current injection drug use (82 of 168). Ninety-five individuals were seen by an HCV specialist (57% of HCV RNA+), 72 started treatment (43%), and 69 (41%) completed treatment. Individuals with primary care providers were most likely to start treatment. Four individuals were diagnosed with hepatitis B; 0 were diagnosed with HIV.<br />Conclusions: The implementation of an OTP-based screening and navigation protocol has enabled significant gains in the identification and treatment of VH in this high prevalence setting.<br /> (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
- Subjects :
- Adult
Antibodies, Viral isolation & purification
Colorado epidemiology
Delivery of Health Care, Integrated organization & administration
Delivery of Health Care, Integrated statistics & numerical data
Female
Follow-Up Studies
HIV genetics
HIV immunology
HIV isolation & purification
HIV Infections epidemiology
HIV Infections therapy
HIV Infections transmission
HIV Testing statistics & numerical data
Health Plan Implementation
Hepacivirus genetics
Hepacivirus immunology
Hepacivirus isolation & purification
Hepatitis C epidemiology
Hepatitis C therapy
Hepatitis C transmission
Humans
Male
Middle Aged
Opioid-Related Disorders complications
Prevalence
Program Evaluation
Prospective Studies
RNA, Viral isolation & purification
Substance Abuse Treatment Centers organization & administration
HIV Infections diagnosis
Hepatitis C diagnosis
Mass Screening statistics & numerical data
Opioid-Related Disorders therapy
Substance Abuse Treatment Centers statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6613
- Volume :
- 222
- Issue :
- Suppl 5
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 32877565
- Full Text :
- https://doi.org/10.1093/infdis/jiz694