The hepatitis C cascade of care in people who inject drugs in Dar es Salaam, Tanzania
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
The World Health Organisation has recently called for hepatitis C virus (HCV) elimination and has identified people who inject drugs (PWID) as a key population to scale‐up screening and linkage to care. This study reports the cascade of care for HCV in PWID attending the largest opioid substitution treatment (OST) clinic in Dar‐es‐Salaam, Tanzania. Between February 2011 and March 2016, HCV serology for all PWID registered at the Muhimbili National Hospital OST clinic, Dar‐es‐Salaam were obtained from records. In 2015 consecutive HCV‐seropositive PWID were invited to undergo a clinical evaluation including epidemiological questionnaire, liver stiffness measurement (Fibroscan) and virological analysis (HCV RNA viral load and genotyping). During the study period, 1,350 persons registered at the OST clinic: all had a HCV serology including 409 (30%) positive results. Among the HCV‐seropositive individuals, 207 (51%) were active attenders and 153 (37%) were enrolled for clinical assessment: 141 (92%) were male, median age: 38 years (IQR 34‐41), and 65 (44%) were co‐infected with HIV; 116 patients (76%) had detectable HCV RNA, with genotypes 1a (68%) and 4a (32%); 21 (17%) had clinically significant fibrosis (≥F2) and 6 (5%) had cirrhosis (F4). None were offered HCV treatment. Chronic hepatitis C among PWID enrolled in the OST centre in Dar‐es‐Salaam is frequent, but its continuum of care is insufficient; integration of HCV diagnosis and treatment should form a part of OST intervention in PWID in Tanzania.
Date Issued
2018-12
Date Acceptance
2018-05-17
Citation
Journal of Viral Hepatitis, 2018, 25 (12), pp.1438-1445
ISSN
1352-0504
Publisher
Wiley
Start Page
1438
End Page
1445
Journal / Book Title
Journal of Viral Hepatitis
Volume
25
Issue
12
Copyright Statement
© 2018 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd
This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Sponsor
Wellcome Trust
Wellcome Trust
Wellcome Trust
Wellcome Trust
Wellcome Trust
Identifier
https://onlinelibrary.wiley.com/doi/full/10.1111/jvh.12966
Grant Number
097816/Z/11/ZR
097816/Z/11/A
097816/Z/11/B
105603/Z/14/Z
204834/Z/16/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Infectious Diseases
Virology
cascade of care
fibrosis
hepatitis C virus
people who inject drugs
Sub-Saharan Africa
LIVER FIBROSIS ASSESSMENT
TRANSIENT ELASTOGRAPHY
PLATELET RATIO
HARM REDUCTION
HCV
PREVALENCE
USERS
HIV
INFECTIONS
DISEASE
Sub-Saharan Africa
cascade of care
fibrosis
hepatitis C virus
people who inject drugs
1103 Clinical Sciences
1108 Medical Microbiology
Gastroenterology & Hepatology
Publication Status
Published
Date Publish Online
2018-07-03