Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study

Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-t...

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Autores principales:	Bianca Granozzi, Viola Guardigni, Lorenzo Badia, Elena Rosselli Del Turco, Alberto Zuppiroli, Beatrice Tazza, Pietro Malosso, Stefano Pieralli, Pierluigi Viale, Gabriella Verucchi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	PWID homeless persons HCV eradication direct-acting antivirals out-of-hospital retention in care Medicine R
Acceso en línea:	https://doaj.org/article/6225755aee0c47c5bb3c60d02ae9b03d
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spelling	oai:doaj.org-article:6225755aee0c47c5bb3c60d02ae9b03d2021-11-11T17:35:22ZOut-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study10.3390/jcm102149552077-0383https://doaj.org/article/6225755aee0c47c5bb3c60d02ae9b03d2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4955https://doaj.org/toc/2077-0383Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-treat patients when managed for HCV in hospital or in an out-of-hospital setting. Methods. In our retrospective study, we categorized the included patients (PWID and homeless persons) into two groups according to whether anti-HCV treatment was offered and provided in a hospital or an out-of-hospital setting. We run logistic regressions to evaluate factors associated with retention in care (defined as the completion of direct antiviral agents (DAAs) therapy). Results. We included 56 patients in our study: 27 were in the out-of-hospital group. Overall, 33 patients completed DAAs therapy. A higher rate of retention in care was observed in the out-of-hospital group rather than in-hospital group (<i>p</i> = 0.001). At the univariate analysis, retention in care was associated with the out-of-hospital management (<i>p</i> = 0.002) and with a shorter time between the first visit and the scheduled start of DAAs (<i>p</i> = 0.003). Conclusions. The choice of treatment models that can better adapt to difficult-to-treat populations, such as an out-of-hospital approach, will be important for achieving the eradication of HCV infection.Bianca GranozziViola GuardigniLorenzo BadiaElena Rosselli Del TurcoAlberto ZuppiroliBeatrice TazzaPietro MalossoStefano PieralliPierluigi VialeGabriella VerucchiMDPI AGarticlePWIDhomeless personsHCV eradicationdirect-acting antiviralsout-of-hospitalretention in careMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4955, p 4955 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	PWID homeless persons HCV eradication direct-acting antivirals out-of-hospital retention in care Medicine R
spellingShingle	PWID homeless persons HCV eradication direct-acting antivirals out-of-hospital retention in care Medicine R Bianca Granozzi Viola Guardigni Lorenzo Badia Elena Rosselli Del Turco Alberto Zuppiroli Beatrice Tazza Pietro Malosso Stefano Pieralli Pierluigi Viale Gabriella Verucchi Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
description	Background. People who inject drugs (PWID) and homeless people represent now a large reservoir of Hepatitis C virus (HCV) infection. However, Hepatis C elimination programs can barely reach these subgroups of patients. We aimed to evaluate and compare the retention in care among these difficult-to-treat patients when managed for HCV in hospital or in an out-of-hospital setting. Methods. In our retrospective study, we categorized the included patients (PWID and homeless persons) into two groups according to whether anti-HCV treatment was offered and provided in a hospital or an out-of-hospital setting. We run logistic regressions to evaluate factors associated with retention in care (defined as the completion of direct antiviral agents (DAAs) therapy). Results. We included 56 patients in our study: 27 were in the out-of-hospital group. Overall, 33 patients completed DAAs therapy. A higher rate of retention in care was observed in the out-of-hospital group rather than in-hospital group (<i>p</i> = 0.001). At the univariate analysis, retention in care was associated with the out-of-hospital management (<i>p</i> = 0.002) and with a shorter time between the first visit and the scheduled start of DAAs (<i>p</i> = 0.003). Conclusions. The choice of treatment models that can better adapt to difficult-to-treat populations, such as an out-of-hospital approach, will be important for achieving the eradication of HCV infection.
format	article
author	Bianca Granozzi Viola Guardigni Lorenzo Badia Elena Rosselli Del Turco Alberto Zuppiroli Beatrice Tazza Pietro Malosso Stefano Pieralli Pierluigi Viale Gabriella Verucchi
author_facet	Bianca Granozzi Viola Guardigni Lorenzo Badia Elena Rosselli Del Turco Alberto Zuppiroli Beatrice Tazza Pietro Malosso Stefano Pieralli Pierluigi Viale Gabriella Verucchi
author_sort	Bianca Granozzi
title	Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_short	Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_full	Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_fullStr	Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_full_unstemmed	Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study
title_sort	out-of-hospital treatment of hepatitis c increases retention in care among people who inject drugs and homeless persons: an observational study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/6225755aee0c47c5bb3c60d02ae9b03d
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Out-of-Hospital Treatment of Hepatitis C Increases Retention in Care among People Who Inject Drugs and Homeless Persons: An Observational Study

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