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

Klein, MB (通讯作者),McGill Univ, Hlth Ctr, Montreal, PQ, Canada.;Klein, MB (通讯作者),CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.
2022-6-24
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.
FRONTIERS IN PUBLIC HEALTH
卷号:10
收录类别:SCIE
语种
英语
来源机构
McGill University; McGill University; McGill University; McGill University
资助机构
Gilead LEGA-C NoCo Program
资助信息
MK has received funding through the Gilead LEGA-C NoCo Program [Grant number IN-US-334-4492, June 1st 2018] for the development of this investigator-initiated study.
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
0
2013以来使用计数
0
EISSN
2296-2565
出版年
2022-6-24
DOI
10.3389/fpubh.2022.877585
WOS学科分类
Public, Environmental & Occupational Health
学科领域
循证公共卫生
关键词
Hepatitis C antiviral agents people who inject drugs Indigenous peoples sexual and gender minorities