title: Treatment of chronic hepatitis C infection among current and former injection drug users within a multidisciplinary treatment model at a community health centre.
abstract: The aim of the present prospective observational study was to assess uptake and success of hepatitis C virus (HCV) treatment among a group of former and current injection drug users with chronic HCV infection at the Street Health Centre in Kingston, Ontario. The Street Health Centre offers hepatitis C education, assessment and treatment within a multidisciplinary, integrated and collaborative treatment model of care delivered by primary care professionals. The study enrolled a convenience sample of 34 patients. Seventy per cent of study patients had no postsecondary education, 85% were unemployed and one-third were unstably housed. A majority of study patients self-reported mental health problems. Of the 14 patients who initiated antiviral treatment in the study period, eight (57%) achieved sustained virological response. Regardless of virological outcome, patients who initiated treatment showed positive trends toward increased social and psychiatric stability, and decreases in high-risk behaviours. These results suggest that not only is successful treatment of chronic HCV infection in current and former injection drug users with concurrent psychiatric disorders possible, but the benefits of such treatment delivered in a community-based, multidisciplinary, primary care model may extend beyond narrowly defined virological outcomes.
authors.affiliation: Street Health Centre, Kingston Community Health Centres, Queen's University, Kingston, Ontario. adamn@streethealth.kchc.ca
authors.forename: Adam Isaiah
authors.initials: AI
authors.lastname: Newman
authors.forename: Shelley
authors.initials: S
authors.lastname: Beckstead
authors.forename: David
authors.initials: D
authors.lastname: Beking
authors.forename: Susan
authors.initials: S
authors.lastname: Finch
authors.forename: Tina
authors.initials: T
authors.lastname: Knorr
authors.forename: Carol
authors.initials: C
authors.lastname: Lynch
authors.forename: Meredith
authors.initials: M
authors.lastname: MacKenzie
authors.forename: Daphne
authors.initials: D
authors.lastname: Mayer
authors.forename: Brenda
authors.initials: B
authors.lastname: Melles
authors.forename: Ron
authors.initials: R
authors.lastname: Shore
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D003151:Community Health Centers; D003153:Community Health Services / Q000379:methods; D003695:Delivery of Health Care; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D009864:Ontario; D010348:Patient Care Team; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a