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Title: Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate but higher rates of loss to follow-up.
Austin Authors: Clark, Paul J;Valery, Patricia C;Ward, James;Strasser, Simone I;Weltman, Martin;Thompson, Alexander;Levy, Miriam T;Leggett, Barbara;Zekry, Amany;Rong, Julian;Angus, Peter W ;George, Jacob;Bollipo, Steven;McGarity, Bruce;Sievert, William;Macquillan, Gerry;Tse, Edmund;Nicoll, Amanda;Wade, Amanda;Chu, Geoff;Harding, Damian;Cheng, Wendy;Farrell, Geoff;Roberts, Stuart K
Affiliation: Department of Gastroenterology, Mater Hospital Brisbane, Raymond Terrace, South Brisbane, QLD, 4101, Australia..
QIMR Berghofer Medical Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia..
UQ Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia..
AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia..
Hepatology Services, Nepean Hospital, Penrith, NSW, Australia..
Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia..
Department of Gastroenterology and Liver, Liverpool Hospital, Sydney, NSW, Australia..
Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia..
Department of Gastroenterology and Hepatology, St George Hospital, Sydney, NSW, Australia..
Gippsland Gastroenterology, Latrobe Regional Hospital, Traralgon, VIC, 3844, Australia..
Gastroenterology and Hepatology
Storr Liver Unit, Westmead Hospital, Westmead, NSW, Australia..
Gastroenterology Department, John Hunter Hospital, New Lambton, NSW, Australia..
Bathurst Liver Clinic Bathurst Hospital, Bathurst, NSW, Australia..
Gastrointestinal and Liver Unit, Monash Health, Melbourne, VIC, Australia..
Liver Transplant Unit Sir Charles Gairdner Hospital, Nedlands Perth, WA, Australia..
Hepatology, Royal Adelaide Hospital, Adelaide, SA, Australia..
Eastern Health Box, Hill, VIC, Australia..
Barwon Health Liver Clinic University Hospital, Geelong, VIC, Australia..
Orange Liver Clinic, Orange Hospital, Orange, NSW, Australia..
Department of Gastroenterology and Hepatology, Lyell McEwin Hospital, Vale, SA, Australia..
Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, WA, Australia..
Gastroenterology and Hepatology Unit Canberra Hospital, Canberra, ACT, Australia..
The Alfred Hospital, Melbourne, VIC, Australia..
Department of Gastroenterology, Princess Alexandra Hospital, Alcohol and Drug Assessment Unit, Inala Indigenous Health Centre and Faculty of Medicine, The University of Queensland, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia..
Issue Date: 11-Jul-2022
Date: 2022
Publication information: BMC gastroenterology 2022; 22(1): 339
Abstract: First Nations Peoples of Australia are disproportionally affected by hepatitis C (HCV) infection. Through a prospective study we evaluated the outcome of direct-acting antiviral (DAA) therapy among First Nations Peoples with HCV infection. Adults who initiated DAA therapy at one of 26 hospitals across Australia, 2016-2019 were included in the study. Clinical data were obtained from medical records and the Pharmaceutical and Medicare Benefits Schemes. Outcomes included sustained virologic response (SVR) and loss to follow-up (LTFU). A multivariable analysis assessed factors associated with LTFU. Compared to non-Indigenous Australians (n = 3206), First Nations Peoples (n = 89) were younger (p < 0.001), morel likely to reside in most disadvantaged (p = 0.002) and in regional/remote areas (p < 0.001), and had similar liver disease severity. Medicines for mental health conditions were most commonly dispensed among First Nations Peoples (55.2% vs. 42.8%; p = 0.022). Of 2910 patients with follow-up data, both groups had high SVR rates (95.3% of First Nations Peoples vs. 93.2% of non-Indigenous patients; p = 0.51) and 'good' adherence (90.0% vs. 86.9%, respectively; p = 0.43). However, 28.1% of First Nations Peoples were LTFU vs. 11.2% of non-Indigenous patients (p < 0.001). Among First Nations Peoples, younger age (adj-OR = 0.93, 95% CI 0.87-0.99) and treatment initiation in 2018-2019 vs. 2016 (adj-OR = 5.14, 95% CI 1.23-21.36) predicted LTFU, while higher fibrosis score was associated with better engagement in HCV care (adj-OR = 0.71, 95% CI 0.50-0.99). Our data showed that First Nations Peoples have an equivalent HCV cure rate, but higher rates of LTFU. Better strategies to increase engagement of First Nations Peoples with HCV care are needed.
DOI: 10.1186/s12876-022-02416-5
Journal: BMC gastroenterology
PubMed URL: 35820850
PubMed URL:
Type: Journal Article
Subjects: Data linkage
Liver fibrosis
Loss to follow-up
Sustained viral response
Appears in Collections:Journal articles

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