Interventions to Improve Uptake of Direct-Acting Antivirals for Hepatitis C Virus in Priority Populations: A Systematic Review

Frontiers in Public Health

article

David Ortiz-Paredes¹  Afia Amoako²  Taline Ekmekjian³  Kim Engler¹  Bertrand Lebouché¹  Marina B. Klein⁵ 

[1] Center for Outcome Research and Evaluation, Research Institute of the McGill University Health Center;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University;Medical Libraries, McGill University Health Center;Department of Family Medicine, McGill University;Division of Infectious Diseases/Chronic Viral Illness Service, Department of Medicine, Glen site, McGill University Health Center;CIHR Canadian HIV Trials Network

关键词: Hepatitis C;    antiviral agents;    people who inject drugs;    Indigenous peoples;    sexual and gender minorities;   

DOI  :  10.3389/fpubh.2022.877585

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background & Objective Access to Hepatitis C (HCV) care remains suboptimal. This systematic review sought to identify existing interventions designed to improve direct-acting antiviral (DAA) uptake among HCV infected women, people who inject drugs (PWID), men who have sex with men (MSM), and Indigenous peoples. Methods Studies published in high- and middle-income countries were retrieved from eight electronic databases and gray literature (e.g., articles, research reports, theses, abstracts) were screened by two independent reviewers. Identified interventions were summarized using textual narrative synthesis. Results After screening 3,139 records, 39 studies were included (11 controlled comparative studies; 36 from high-income countries). Three groups of interventions were identified: interventions involving patients; providers; or the healthcare system. Interventions directed to patients included care co-ordination, accelerated DAA initiation, and patient education. Interventions involving providers included provider education, telemedicine, multidisciplinary teams, and general practitioner-led care. System-based interventions comprised DAA universal access policies and offering HCV services in four settings (primary care, secondary care, tertiary care, and community settings). Most studies (30/39) described complex interventions, i.e., those with two or more strategies combined. Most interventions (37/39) were tailored to, or studied among, PWID. Only one study described an intervention that was aimed at women. Conclusions Combining multiple interventions is a common approach for supporting DAA initiation. Three main research gaps were identified, specifically, a lack of: (1) controlled trials estimating the individual or combined effects of interventions on DAA uptake; (2) studies in middle-income countries; and (3) interventions tailored to women, MSM, and Indigenous people.

【 授权许可】

CC BY