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https://www.readbyqxmd.com/read/29624813/feasibility-of-reaching-world-health-organization-targets-for-hepatitis-c-and-the-cost-effectiveness-of-alternative-strategies
#1
Torbjørn Wisløff, Richard White, Olav Dalgard, Ellen J Amundsen, Hinta Meijerink, Hilde Kløvstad
New drugs for treating hepatitis C have considerably increased the probability of being cured. Treatment uptake, however, is still low. The objectives of this study were to analyse the impact of initiatives that may increase the proportion of infected people on treatment and interventions aimed at reducing the incidence of new infection among people who inject drugs. A compartmental model for Norway was used to simulate hepatitis C and related complications. We analysed two different screening initiatives aimed to increase the proportion of infected people on treatment...
April 6, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29594179/intervention-packages-to-reduce-the-impact-of-hiv-and-hcv-infections-among-people-who-inject-drugs-in-eastern-europe-and-central-asia-a-modeling-and-cost-effectiveness-study
#2
Guillaume Mabileau, Otilia Scutelniciuc, Maia Tsereteli, Ivan Konorazov, Alla Yelizaryeva, Svetlana Popovici, Karimov Saifuddin, Elena Losina, Manoela Manova, Vinay Saldanha, Jean-Elie Malkin, Yazdan Yazdanpanah
Background: We evaluated the effectiveness and cost-effectiveness of interventions targeting hepatitis C virus (HCV) and HIV infections among people who inject drugs (PWID) in Eastern Europe/Central Asia. We specifically considered the needle-syringe program (NSP), opioid substitution therapy (OST), HCV and HIV diagnosis, antiretroviral therapy (ART), and/or new HCV treatment (direct acting antiviral [DAA]) in Belarus, Georgia, Kazakhstan, Republic of Moldova, and Tajikistan. Methods: We developed a deterministic dynamic compartmental model and evaluated the number of infections averted, costs, and incremental cost-effectiveness ratios (ICERs) of interventions...
March 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29559070/anova-health-institute
#3
Johannes M Hugo, Kevin B Rebe, Evan Tsouroulis, Anthony Manion, Glenn de Swart, Helen Struthers, James A McIntyre
Chemsex is the colloquial term used for a specific pattern of drug use that is increasingly common among men who have sex with men (MSM) globally. The recreational substances employed are used specifically in a sexualized context. The reasons for chemsex among MSM are complex. The Anova Health Institute (Anova) provided harm-reduction services in Cape Town, South Africa in 2013 and 2014. This project, known as Tikking the Boxes had two objectives: first to provide direct harm-reduction services to drug-using MSM in Cape Town, South Africa, and second, to reduce HIV and hepatitis B and C transmission among this population...
March 21, 2018: Sexual Health
https://www.readbyqxmd.com/read/29531415/lead-poisoning-outbreak-among-opium-users-in-the-islamic-republic-of-iran-2016-2017
#4
Talat Ghane, Nasim Zamani, Hossein Hassanian-Moghaddam, Ali Beyrami, Alireza Noroozi
Objective: To describe an outbreak of lead poisoning among opium users in the Islamic Republic of Iran and estimate the number of affected people in the country. Methods: We used data from the country's largest poison treatment centre to illustrate the epidemiology of an outbreak of lead poisoning in oral opium users. We describe the government's referral and treatment guidelines in response to the outbreak. Based on the number of individuals treated and previous studies on the prevalence of oral opium use we estimated the total number of people at risk of lead-contaminated opium nationwide...
March 1, 2018: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29486974/use-of-epidural-clonidine-for-the-management-of-analgesia-in-the-opioid-addicted-parturient-on-buprenorphine-maintenance-therapy-an-observational-study
#5
M R Hoyt, U Shah, J Cooley, M Temple
OBJECTIVES: Management of labor analgesia and post-cesarean delivery pain is challenging in the patient taking buprenorphine as opioid addiction maintenance therapy. We observed whether substituting clonidine for fentanyl in an epidural solution would provide adequate analgesia for labor and after cesarean delivery. METHODS: We substituted our standard 2 µg/mL fentanyl in 0.0625% bupivacaine epidural solution with 2 µg/mL clonidine in 0.0625% bupivacaine, or 1...
January 31, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29482150/identifying-injection-drug-use-and-estimating-population-size-of-people-who-inject-drugs-using-healthcare-administrative-datasets
#6
Naveed Zafar Janjua, Nazrul Islam, Margot Kuo, Amanda Yu, Stanley Wong, Zahid A Butt, Mark Gilbert, Jane Buxton, Nuria Chapinal, Hasina Samji, Mei Chong, Maria Alvarez, Jason Wong, Mark W Tyndall, Mel Krajden
BACKGROUND: Large linked healthcare administrative datasets could be used to monitor programs providing prevention and treatment services to people who inject drugs (PWID). However, diagnostic codes in administrative datasets do not differentiate non-injection from injection drug use (IDU). We validated algorithms based on diagnostic codes and prescription records representing IDU in administrative datasets against interview-based IDU data. METHODS: The British Columbia Hepatitis Testers Cohort (BC-HTC) includes ∼1...
February 23, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29482055/predictors-of-injecting-cessation-among-a-cohort-of-people-who-inject-drugs-in-tijuana-mexico
#7
Danielle Horyniak, Steffanie A Strathdee, Brooke S West, Meredith Meacham, Gudelia Rangel, Tommi L Gaines
INTRODUCTION: Little is known about the cessation of injecting drug use (IDU) among people who inject drugs (PWID) in low and middle-income settings, where access to effective interventions for reducing drug use (e.g., opioid substitution treatment; OST), may be limited. We measured the incidence and identified predictors of IDU cessation among a cohort of PWID in Tijuana, Mexico. METHODS: Data were drawn from 621 participants in Proyecto El Cuete IV, a prospective cohort of PWID recruited in 2011 and interviewed biannually to 2016...
February 21, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29450210/sofosbuvir-based-direct-acting-antiviral-therapies-for-hcv-in-people-receiving-opioid-substitution-therapy-an-analysis-of-phase-3-studies
#8
Jason Grebely, Jordan J Feld, David Wyles, Mark Sulkowski, Liyun Ni, Joe Llewellyn, Heshaam M Mir, Nika Sajed, Luisa M Stamm, Robert H Hyland, John McNally, Diana M Brainard, Ira Jacobson, Stefan Zeuzem, Marc Bourlière, Graham Foster, Nezam Afdhal, Gregory J Dore
Background: Hepatitis C virus (HCV) direct-acting antiviral therapy is effective among people receiving opioid substitution therapy (OST), but studies are limited by small numbers of nongenotype 1 (GT1) patients. The aim of this study was to evaluate the treatment completion, adherence, SVR12, and safety of sofosbuvir-based therapies in HCV patients receiving and not receiving OST. Methods: Ten phase 3 studies of sofosbuvir-based regimens included ION (ledipasvir/sofosbuvir ± ribavirin for 8, 12, or 24 weeks in GT1), ASTRAL (sofosbuvir/velpatasvir for 12 weeks in GT1-6), and POLARIS (sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir in GT1-6)...
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29381697/policy-responses-to-hepatitis-c-in-the-nordic-countries-gaps-and-discrepant-reporting-in-the-hep-nordic-study
#9
Kelly Safreed-Harmon, Kristina L Hetherington, Soo Aleman, Hannu Alho, Olav Dalgard, Tove Frisch, Magnus Gottfredsson, Nina Weis, Jeffrey V Lazarus
BACKGROUND AND AIMS: In the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden), the prevalence of chronic hepatitis C virus (HCV) infection is relatively low in the general population, but is much higher among people who inject drugs (PWID). We conducted an exploratory study to investigate the extent to which these countries have policies supporting key elements of the public health response that is necessary to achieve the global goal of eliminating HCV as a public health threat...
2018: PloS One
https://www.readbyqxmd.com/read/29368662/treatment-outcomes-in-patients-with-opioid-use-disorder-initiated-by-prescription-a-systematic-review-protocol
#10
Nitika Sanger, Meha Bhatt, Laura Zielinski, Stephanie Sanger, Hamnah Shahid, Bianca Bantoto, M Constantine Samaan, Russell de Souza, Zainab Samaan
BACKGROUND: In North America, opioid use has become a public health crisis with policy makers declaring it a state of emergency. Opioid substitution therapy (OST) is a harm-reduction method used in treating opioid use disorder. While OST has shown to be successful in improving treatment outcomes, there is still a great degree of variability among patients. This cohort of patients has shifted from young males using heroin to a greater number of older people and women using prescription opioids...
January 25, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29359361/direct-acting-antiviral-treatment-of-chronic-hcv-infected-patients-on-opioid-substitution-therapy-still-a-concern-in-clinical-practice
#11
Stefan Christensen, Peter Buggisch, Stefan Mauss, Klaus H W Böker, Eckart Schott, Hartwig Klinker, Tim Zimmermann, Bernd Weber, Jens Reimer, Yvonne Serfert, Heiner Wedemeyer
BACKGROUND AND AIMS: There is limited real-world information on the effectiveness of antiviral treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals (DAA) in people on opioid substitution therapy (OST). This study compared sustained virological response (SVR) rates and proportion of lost to follow-up (LTFU) between OST and non-OST patients in the German Hepatitis C-Registry (DHC-R). DESIGN: National multi-centre prospective real-world registry (German Hepatitis C-Registry, DHC-R)...
January 23, 2018: Addiction
https://www.readbyqxmd.com/read/29334921/a-pilot-feasibility-randomised-controlled-trial-of-an-adjunct-brief-social-network-intervention-in-opiate-substitution-treatment-services
#12
Ed Day, Alex Copello, Jennifer L Seddon, Marilyn Christie, Deborah Bamber, Charlotte Powell, Carmel Bennett, Shabana Akhtar, Sanju George, Andrew Ball, Emma Frew, Ilias Goranitis, Nick Freemantle
BACKGROUND: Approximately 3% of people receiving opioid substitution therapy (OST) in the UK manage to achieve abstinence from prescribed and illicit drugs within three years of commencing treatment. Involvement of families and wider social networks in supporting psychological treatment may be an effective strategy in facilitating recovery, and this pilot study aimed to evaluate the impact of a social network-focused intervention for patients receiving OST. METHODS: A two-site, open feasibility trial randomised patients receiving OST for at least 12 months but still reporting illicit opiate use in the past 28 days to one of three treatments: 1) treatment as usual (TAU), 2) Brief Social Behaviour and Network Therapy (B-SBNT) + TAU, or 3) Personal Goal Setting (PGS) + TAU...
January 15, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29310928/sofosbuvir-and-velpatasvir-for-hepatitis-c-virus-infection-in-people-with-recent-injection-drug-use-simplify-an-open-label-single-arm-phase-4-multicentre-trial
#13
Jason Grebely, Olav Dalgard, Brian Conway, Evan B Cunningham, Philip Bruggmann, Behzad Hajarizadeh, Janaki Amin, Julie Bruneau, Margaret Hellard, Alain H Litwin, Philippa Marks, Sophie Quiene, Sharmila Siriragavan, Tanya L Applegate, Tracy Swan, Jude Byrne, Melanie Lacalamita, Adrian Dunlop, Gail V Matthews, Jeff Powis, David Shaw, Maria Christine Thurnheer, Martin Weltman, Ian Kronborg, Curtis Cooper, Jordan J Feld, Chris Fraser, John F Dillon, Phillip Read, Ed Gane, Gregory J Dore
BACKGROUND: Despite revised guidelines that no longer exclude people who inject drugs (PWID) from treatment for hepatitis C virus (HCV) infection, many clinicians are reluctant to treat recent PWID. This study aimed to evaluate the efficacy of sofosbuvir and velpatasvir therapy in people with chronic HCV infection and recent injection drug use. METHODS: In this open-label, single-arm phase 4 trial (SIMPLIFY), we recruited participants with recent injection drug use (past 6 months) and chronic HCV genotype 1-6 infection from seven countries (19 sites)...
January 5, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29284807/a-clinical-study-of-opioid-substitution-therapy-in-a-tertiary-care-center-of-eastern-india
#14
Satyakam Mohapatra, Mihir Ranjan Nayak, Manaswini Dash
Background: Opioid substitution therapy (OST) is an evidence-based intervention for opiate-dependent persons that replaces illicit drug use with medically prescribed, orally administered opiates such as buprenorphine and methadone. OST reduces HIV risk behaviors and harms associated with injecting opioid. Most of the evidence for OST effectiveness has been generated in middle- and high-income countries where programs are mostly located in dedicated health-care settings; evidence regarding the outcomes of OST programs in low-income countries where OST is often provided in grassroots settings such as drop-in centers is limited...
November 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/29234968/a-cross-national-analysis-of-the-association-between-years-of-implementation-of-opioid-substitution-treatments-and-drug-related-deaths-in-europe-from-1995-to-2013
#15
Phillip L Marotta, Charlotte A McCullagh
Data at the individual-level provide evidence that opioid substitution treatment (OST) programs protect against mortality for opioid dependent populations. Prior research has not examined the merits of national implementation of opioid substitution programs for reducing mortality at the country-level. This study elucidates longitudinal associations between country-level implementation of opioid substitution treatment programs on mortality rates of drug related deaths (DRD) from 1995 to 2013 in 30 European nations...
December 12, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#16
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29208190/preventing-blood-borne-virus-infection-in-people-who-inject-drugs-in-the-uk-systematic-review-stakeholder-interviews-psychosocial-intervention-development-and-feasibility-randomised-controlled-trial
#17
Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, Noreen Mdege, John Strang, Avril Taylor, Judith Watson
BACKGROUND: Opioid substitution therapy and needle exchanges have reduced blood-borne viruses (BBVs) among people who inject drugs (PWID). Some PWID continue to share injecting equipment. OBJECTIVES: To develop an evidence-based psychosocial intervention to reduce BBV risk behaviours and increase transmission knowledge among PWID, and conduct a feasibility trial among PWID comparing the intervention with a control. DESIGN: A pragmatic, two-armed randomised controlled, open feasibility trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29204843/incidence-and-risk-factors-for-hepatitis-c-virus-infection-among-illicit-drug-users-in-italy
#18
Enea Spada, Giovanni Rezza, Anna Rosa Garbuglia, Flavia Lucia Lombardo, Ornella Zuccaro, Francesca Menniti Ippolito, Elisabetta Cupellaro, Stefania Capone, Maria Rosaria Capobianchi, Alfredo Nicosia, Riccardo Cortese, Antonella Folgori, Alfonso Mele
So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007-2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis...
December 4, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/29181853/towards-the-elimination-of-hepatitis-c-in-the-united-states
#19
Sammy Saab, Long Le, Satvir Saggi, Vinay Sundaram, Myron Tong
The emergence of effective direct-acting antiviral (DAA) agents has reignited discussion over hepatitis C elimination potential in the United States. Eliminating hepatitis C will require a critical examination regarding technical feasibility, economic considerations, and social/political attention. Tremendous advancement has been made in recent years with the availability of sensitive diagnostic tests and highly effective DAAs capable of achieving sustained viral response (SVR) in more than 95% of patients...
November 27, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29179255/excess-overdose-mortality-immediately-following-transfer-of-patients-and-their-care-as-well-as-after-cessation-of-opioid-substitution-therapy
#20
Karolina M Bogdanowicz, Robert Stewart, Chin-Kuo Chang, Hitesh Shetty, Mizanur Khondoker, Edward Day, Richard D Hayes, John Strang
AIMS: To investigate clustering of all-cause and overdose deaths after a transfer of patients and their care to alternative treatment provider and after the end of opioid substitution therapy (OST) in opioid-dependent individuals in specialist addiction treatment. DESIGN, SETTING AND PARTICIPANTS: Mortality data were identified within a sample of 5335 patients with opioid use disorder who had received OST treatment between 1 April 2008 and 31 December 2013 from a large mental health-care provider in the United Kingdom...
November 27, 2017: Addiction
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