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Viruses
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Cascade of Care for HIV and Hepatitis
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Cascade of Care for HIV and Hepatitis

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 8580

Special Issue Editor

Prof. Dr. Justyna Dominika Kowalska

E-Mail Website
Guest Editor
Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
Interests: HIV; AIDS; cascade; linkage; hepatitis

Special Issue Information

Dear Colleagues,

The care cascade is a concept used to assess and improve the engagement of people living with HIV at various stages of HIV care and treatment. It helps identify gaps in continuity of care and develop strategies to ensure that people living with HIV receive the health services and support that they need. This concept was so effective that it deserved to be transferred to other infectious diseases, especially hepatitis B virus (HBV) and hepatitis C virus (HCV).

This comprehensive approach ensures that individuals receive the screening, diagnosis, treatment and support that they need, ultimately improving their overall health and well-being. Promoting the well-being of people living with HIV goes beyond clinical care to address their overall quality of life and holistic health.

The purpose of this Special Issue is to collect research related to HIV and viral hepatitis, covering topics ranging from early diagnosis and effective treatment to well-being and quality of life.

Prof. Dr. Justyna Dominika Kowalska
Guest Editor

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Keywords

  • HIV
  • AIDS
  • cascade
  • linkage
  • HCV
  • HBV

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Published Papers (7 papers)

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Research

11 pages, 2511 KiB  
Article
How Do Time Since Diagnosis and Sociodemographic Factors Influence Attitudes Towards HIV Status Disclosure in People Living with HIV in Poland? Data from Go Holistic Go Beyond Project
by Martyna Lara, Dominik Bursa, Błażej Rozpłochowski, Agata Waszczuk, Monika Bociąga-Jasik and Justyna D. Kowalska
Viruses 2024, 16(11), 1771; https://doi.org/10.3390/v16111771 - 13 Nov 2024
Viewed by 437
Abstract
The aim of this publication is to present the data from Polish respondents of the Go Holistic Go Beyond Project, which investigates social, professional and intimate relations of people living with HIV in Central and Eastern Europe. We analyze how the patients’ attitude [...] Read more.
The aim of this publication is to present the data from Polish respondents of the Go Holistic Go Beyond Project, which investigates social, professional and intimate relations of people living with HIV in Central and Eastern Europe. We analyze how the patients’ attitude towards disclosing their HIV status changes over time from diagnosis. A questionnaire was distributed among patients by three HIV out-patient clinics. Respondents were compared in three groups defined by the time from diagnosis: over 10 years ago, 6–10 years ago and within 5 years. In total, 381 persons living with HIV participated in the survey, 354 of respondents were male, 23 were female and 4 of the respondents did not identify with any of the above sexes. A significant decrease in hospital-diagnosed cases (from 53% to 39%) was observed, alongside an increased role of private laboratories and voluntary counseling and testing centers. Eighty-nine percent of participants shared their HIV status with at least one social group. There was no significant change in the patterns of HIV status disclosure, reason and form of HIV testing. Our results emphasize the importance of survey-based studies in identifying the needs of people living with HIV in order to improve their general well-being. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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10 pages, 581 KiB  
Article
Knowledge and Awareness of Risk Factors for HIV Infection and about HIV Testing among Medical Students in Warsaw
by Justyna Kowalska, Martyna Cholewik, Carlo Bieńkowski, Aleksandra Maciejczyk, Dominik Bursa and Agata Skrzat-Klapaczyńska
Viruses 2024, 16(9), 1470; https://doi.org/10.3390/v16091470 - 15 Sep 2024
Viewed by 773
Abstract
Background: The number of late diagnoses of HIV remains very high in Poland, leading to a high proportion of patients developing and dying of HIV-related diseases. The main reason for this is the very low utilization of HIV testing. Our analyses aimed to [...] Read more.
Background: The number of late diagnoses of HIV remains very high in Poland, leading to a high proportion of patients developing and dying of HIV-related diseases. The main reason for this is the very low utilization of HIV testing. Our analyses aimed to investigate knowledge about the indications for HIV testing among medical university students, as well as identify their own HIV testing experiences. Material and methods: A cross-sectional survey study was designed to collect information on the students’ demographics and their experiences of HIV testing, as well as their knowledge of virus transmission and the indications for testing. Data were collected as part of the HIV_week@WUM project conducted at the Medical University of Warsaw in parallel with the 18th European AIDS Conference, which took place in Warsaw between 18 and 21 October 2023. Results: In total, 545 questionnaires were collected. The median age of the study participants was 20 (interquartile range (IQR): 19–22 years). The majority of respondents were as follows: women (67.5%), born in Poland (97.8%), and were attending the medical faculty (56.7%). Only 114 (21.43%) participants had ever been tested for HIV. For all modes of HIV transmission, most of the respondents overestimated the risk of acquiring HIV, but, at the same time, they had never been tested for HIV. Conclusions: Only one in five health sciences students has ever had a test for HIV, which is less than estimates for the general population of Warsaw. There is an ongoing need to popularize testing among future health care providers in order to address both the indications for testing for individuals and the better use of HIV testing in clinical practice. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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15 pages, 1855 KiB  
Article
HCV Cascade of Care in HIV/HCV Co-Infected Individuals: Missed Opportunities for Micro-Elimination
by Christos Thomadakis, Dimitrios Basoulis, Olga Tsachouridou, Konstantinos Protopapas, Vasilios Paparizos, Myrto Astriti, Maria Chini, Georgios Chrysos, Markos Marangos, Periklis Panagopoulos, Diamantis Kofteridis, Helen Sambatakou, Elpida Mastrogianni, Nikos Panatzis, Evmorfia Pechlivanidou, Mina Psichοgiou and Giota Touloumi
Viruses 2024, 16(6), 885; https://doi.org/10.3390/v16060885 - 30 May 2024
Cited by 1 | Viewed by 746
Abstract
People living with HIV-HCV co-infection comprise a target group for HCV-micro-elimination. We conducted an HCV cascade of care (CoC) for HIV-HCV co-infected individuals living in Greece and investigated factors associated with different HCV-CoC stages. We analyzed data from 1213 participants from the Athens [...] Read more.
People living with HIV-HCV co-infection comprise a target group for HCV-micro-elimination. We conducted an HCV cascade of care (CoC) for HIV-HCV co-infected individuals living in Greece and investigated factors associated with different HCV-CoC stages. We analyzed data from 1213 participants from the Athens Multicenter AIDS Cohort Study. A seven-stage CoC, overall and by subgroup (people who inject drugs (PWID), men having sex with men (MSM), men having sex with women (MSW), and migrants], was constructed, spanning from HCV diagnosis to sustained virologic response (SVR). Logistic/Cox regression models were employed to identify factors associated with passing through each CoC step. Among 1213 anti-HCV-positive individuals, 9.2% died before direct-acting antiviral (DAA) availability. PWID exhibited higher mortality rates than MSM. Of 1101 survivors, 72.2% remained in care and underwent HCV-RNA testing. Migrants and PWID showed the lowest retention rates. HCV-RNA was available for 79.2% of those in care, with 77.8% diagnosed with chronic HCV. Subsequently, 71% initiated DAAs, with individuals with very low CD4 counts (<100 cells/μL) exhibiting lower odds of DAA initiation. SVR testing was available for 203 individuals, with 85.7% achieving SVR. The SVR rates did not differ across risk groups. In 2023, significant gaps and between-group differences persisted in HCV-CoC among HIV-HCV co-infected individuals in Greece. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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13 pages, 1998 KiB  
Article
Impact of the COVID-19 Pandemic on Hepatitis C Treatment Initiation in British Columbia, Canada: An Interrupted Time Series Study
by Richard L. Morrow, Mawuena Binka, Julia Li, Mike Irvine, Sofia R. Bartlett, Stanley Wong, Dahn Jeong, Jean Damascene Makuza, Jason Wong, Amanda Yu, Mel Krajden and Naveed Zafar Janjua
Viruses 2024, 16(5), 655; https://doi.org/10.3390/v16050655 - 23 Apr 2024
Cited by 1 | Viewed by 1022
Abstract
We investigated the impacts of the COVID-19 pandemic on hepatitis C (HCV) treatment initiation, including by birth cohort and injection drug use status, in British Columbia (BC), Canada. Using population data from the BC COVID-19 Cohort, we conducted interrupted time series analyses, estimating [...] Read more.
We investigated the impacts of the COVID-19 pandemic on hepatitis C (HCV) treatment initiation, including by birth cohort and injection drug use status, in British Columbia (BC), Canada. Using population data from the BC COVID-19 Cohort, we conducted interrupted time series analyses, estimating changes in HCV treatment initiation following the introduction of pandemic-related policies in March 2020. The study included a pre-policy period (April 2018 to March 2020) and three follow-up periods (April to December 2020, January to December 2021, and January to December 2022). The level of HCV treatment initiation decreased by 26% in April 2020 (rate ratio 0.74, 95% confidence interval [CI] 0.60 to 0.91). Overall, no statistically significant difference in HCV treatment initiation occurred over the 2020 and 2021 post-policy periods, and an increase of 34.4% (95% CI 0.6 to 75.8) occurred in 2022 (equating to 321 additional people initiating treatment), relative to expectation. Decreases in HCV treatment initiation occurred in 2020 for people born between 1965 and 1974 (25.5%) and people who inject drugs (24.5%), relative to expectation. In summary, the pandemic was associated with short-term disruptions in HCV treatment initiation in BC, which were greater for people born 1965 to 1974 and people who inject drugs. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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12 pages, 244 KiB  
Article
Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia
by Beatrice Zovich, Catherine Freeland, Holly Moore, Kara Sapp, Anousha Qureshi, Rachel Holbert, Jason Zambrano, Daljinder Bhangoo, Chari Cohen, Richard W. Hass and Amy Jessop
Viruses 2024, 16(4), 628; https://doi.org/10.3390/v16040628 - 18 Apr 2024
Cited by 2 | Viewed by 1813
Abstract
The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a [...] Read more.
The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher’s exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against HBV, and 17.9% had recovered from a past infection. Eleven (2.2%) participants tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one (0.2%) for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were predictive of previous exposure. This study found high rates of current and past HBV infection, and a 10% HBV/HDV co-infection rate. Despite availability of vaccine, one quarter of participants remained vulnerable to infection. Findings demonstrate the need to improve low-threshold HBV/HDV screening, vaccination, and linkage to care among PWUD. The study also identified gaps in the HBV/HDV care cascade, including lack of point-of-care diagnostics and lack of support for HROs to provide HBV services. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
11 pages, 1063 KiB  
Article
Occult HBV Infection in Patients Infected by HIV or HCV: Comparison between HBV-DNA and Two Assays for HBsAg
by Silvia Meschi, Klizia Mizzoni, Bruno Daniele Leoni, Claudio Galli, Anna Rosa Garbuglia, Stefano Belladonna, Enrico Girardi, Fabrizio Maggi and the HBSAGN Study Group
Viruses 2024, 16(3), 412; https://doi.org/10.3390/v16030412 - 7 Mar 2024
Cited by 1 | Viewed by 1510
Abstract
We investigated the frequency and serological correlates of occult hepatitis B virus infection (OBI) and the potential impact of a highly sensitive assay for HBsAg in subjects infected by human immunodeficiency virus (HIV) or hepatitis C virus (HCV), who are also at risk [...] Read more.
We investigated the frequency and serological correlates of occult hepatitis B virus infection (OBI) and the potential impact of a highly sensitive assay for HBsAg in subjects infected by human immunodeficiency virus (HIV) or hepatitis C virus (HCV), who are also at risk for hepatitis B virus (HBV) infection, often in an occult form. Samples from 499 patients with HIV, all HBsAg negative and anti-HBc positive, and 137 patients with HCV were tested for HBV-DNA, anti-HBc, anti-HBs, and HBsAg by a conventional and highly sensitive assay. HBV biomarkers were detected in 71.5% of HCV-RNA-positive, with a higher prevalence of cases positive only for anti-HBc in patients with HCV than in those with HIV. HBV-DNA was detectable in 0.6% of HIV-positive and 7.3% of HCV-RNA-positive patients. Among patients with HCV, four were positive for HBsAg and negative for HBV-DNA, bringing the rate of HBV-active infection in this group to 10.2%. Active HBV infection was not related to gender or specific patterns of HBV biomarkers but was higher in HCV patients coinfected by HIV compared to those infected only by HCV. Monitoring patients at high risk for HBV infection and reactivation may require testing for both HBV-DNA and HBsAg. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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14 pages, 829 KiB  
Article
Integration of Hepatitis C and Addiction Treatment in People Who Inject Drugs: The San Patrignano HCV-Free and Drug-Free Experience
by Pierluca Piselli, Antonio Boschini, Romina Gianfreda, Alessandra Nappo, Claudia Cimaglia, Gianpaolo Scarfò, Camillo Smacchia, Raffaella Paoletti, Sarah Duehren and Enrico Girardi
Viruses 2024, 16(3), 375; https://doi.org/10.3390/v16030375 - 28 Feb 2024
Viewed by 1418
Abstract
Injection drug use represents an important contributor to hepatitis C virus (HCV) transmission, hence therapeutic communities (TCs) are promising points of care for the identification and treatment of HCV-infected persons who inject drugs (PWIDs). We evaluated the effectiveness and efficacy of an HCV [...] Read more.
Injection drug use represents an important contributor to hepatitis C virus (HCV) transmission, hence therapeutic communities (TCs) are promising points of care for the identification and treatment of HCV-infected persons who inject drugs (PWIDs). We evaluated the effectiveness and efficacy of an HCV micro-elimination program targeting PWIDs in the context of a drug-free TC; we applied the cascade of care (CoC) evaluation by calculating frequencies of infection diagnosis, confirmation, treatment and achievement of a sustained virological response (SVR). We also evaluated the risk of reinfection of PWIDs achieving HCV eradication by collecting follow-up virologic information of previously recovered individuals and eventual relapse in drug use, assuming the latter as a potential source of reinfection. We considered 811 PWIDs (aged 18+ years) residing in San Patrignano TC at the beginning of the observation period (January 2018–March 2022) or admitted thereafter, assessing for HCV and HIV serology and viral load by standard laboratory procedures. Ongoing infections were treated with direct-acting antivirals (DAA), according to the current national guidelines. Out of the 792 individuals tested on admission, 503 (63.5%) were found to be seropositive for antibodies against HCV. A total of 481 of these 503 individuals (95.6%) underwent HCV RNA testing. Out of the 331 participants positive for HCV RNA, 225 were ultimately prescribed a DAA treatment with a sustained viral response (SVR), which was achieved by 222 PWIDs (98.7%). Of the 222 PWIDs, 186 (83.8%) with SVR remained HCV-free on follow-up (with a median follow-up of 2.73 years after SVR ascertainment). The CoC model in our TC proved efficient in implementing HCV micro-elimination, as well as in preventing reinfection and promoting retention in the care of individuals, which aligns with the therapeutic goals of addiction treatment. Full article
(This article belongs to the Special Issue Cascade of Care for HIV and Hepatitis)
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