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Int J Drug Policy. 2015 Oct;26(10):984-91. doi: 10.1016/j.drugpo.2015.07.002. Epub 2015 Jul 16.

Liver disease knowledge and acceptability of non-invasive liver fibrosis assessment among people who inject drugs in the drug and alcohol setting: The LiveRLife Study.

Author information

1
The Kirby Institute, UNSW Australia, NSW, Australia. Electronic address: amarshall@kirby.unsw.edu.au.
2
The Kirby Institute, UNSW Australia, NSW, Australia.
3
Centre for Health and Social Research, Australian Catholic University, VIC, Australia.
4
Centre for Social Research in Health, UNSW Australia, NSW, Australia.
5
NSW Users and AIDS Association, Inc., NSW, Australia.
6
St Vincent's Hospital Sydney, NSW, Australia.
7
Australian Injecting and Illicit Drug Users League, ACT, Australia.
8
Hepatitis NSW, Australia.
9
University of Newcastle, Newcastle, NSW, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia.
10
The Kirby Institute, UNSW Australia, NSW, Australia; Kirketon Road Centre, NSW, Australia.
11
Coffs Harbour Drug and Alcohol Service, NSW, Australia.

Abstract

BACKGROUND:

The aim of this study was to assess factors associated with baseline knowledge of HCV and liver disease, acceptability of transient elastography (TE) assessment (FibroScan(®)), and willingness and intent to receive HCV treatment among persons with a history of injection drug use participating in a liver health promotion campaign.

METHODS:

The LiveRLife campaign involved three phases: (1) campaign resource development; (2) campaign resource testing; and (3) campaign implementation. Participants were enrolled in an observational cohort study with recruitment at four clinics - one primary health care facility, two OST clinics, and one medically supervised injecting centre - in Australia between May and October 2014. Participants received educational material, nurse clinical assessment, TE assessment, dried blood spot testing, and completed a knowledge survey.

RESULTS:

Of 253 participants (mean age 43 years), 68% were male, 71% had injected in the past month, and 75% self-reported as HCV positive. Median knowledge score was 16/23. In adjusted analysis, less than daily injection (AOR 5.01; 95% CI, 2.64-9.51) and no daily injection in the past month (AOR 3.54; 95% CI, 1.80-6.94) were associated with high knowledge (≥16). TE was the most preferred method both pre- (66%) and post-TE (89%) compared to liver biopsy and blood sample. Eighty-eight percent were 'definitely willing' or 'somewhat willing' to receive HCV treatment, and 56% intended to start treatment in the next 12 months. Approximately 68% had no/mild fibrosis (F0/F1, ≥2.5 to ≤7.4kPa), 13% moderate fibrosis (F2, ≥7.5 to ≤9.4kPa), 10% severe fibrosis (F3, ≥9.5 to ≤12.4kPa), and 9% had cirrhosis (F4, ≥12.5kPa).

CONCLUSION:

Liver disease and HCV knowledge was moderate. High acceptability of TE by PWID provides strong evidence for the inclusion of TE in HCV-related care, and could help to prioritise HCV treatment for those at greatest risk of liver disease progression.

KEYWORDS:

Drug users; HCV; Hepatitis C; Knowledge; PWID; Willingness

PMID:
26256938
DOI:
10.1016/j.drugpo.2015.07.002
[Indexed for MEDLINE]

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