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Hermosa S, Goutzamanis S, Doyle J, Higgs P. Reducing alcohol-related harm in people recently treated for hepatitis C. Aust J Prim Health 2019; 25:193-194. [PMID: 31196383 DOI: 10.1071/py19074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/08/2019] [Indexed: 02/28/2024]
Affiliation(s)
- Sasha Hermosa
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia; and Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia; and Corresponding author
| | - Stelliana Goutzamanis
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia; and Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia
| | - Joseph Doyle
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia; and Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia; and Department of Infectious Diseases, Alfred Health, 55 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia; and Department of Public Health, La Trobe University, 360 Collins Street, Melbourne, Vic. 3000, Australia
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Goutzamanis S, Doyle J, Higgs P, Hellard M. Improving hepatitis C direct-acting antiviral access and uptake: A role for patient-reported outcomes and lived experience. J Viral Hepat 2019; 26:218-223. [PMID: 30315689 DOI: 10.1111/jvh.13020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 12/12/2022]
Abstract
Hepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon-free direct-acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for "hard-to-reach" populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population-level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient-reported outcome measures.
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Affiliation(s)
- Stelliana Goutzamanis
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joseph Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne, Australia
| | - Peter Higgs
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne, Australia
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Goutzamanis S, Doyle JS, Thompson A, Dietze P, Hellard M, Higgs P. Experiences of liver health related uncertainty and self-reported stress among people who inject drugs living with hepatitis C virus: a qualitative study. BMC Infect Dis 2018; 18:151. [PMID: 29609552 PMCID: PMC5879642 DOI: 10.1186/s12879-018-3057-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 03/21/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND People who inject drugs (PWID) are most at risk of hepatitis C virus infection in Australia. The introduction of transient elastography (TE) (measuring hepatitis fibrosis) and direct acting antiviral medications will likely alter the experience of living with hepatitis C. We aimed to explore positive and negative influences on wellbeing and stress among PWID with hepatitis C. METHODS The Treatment and Prevention (TAP) study examines the feasibility of treating hepatitis C mono-infected PWID in community settings. Semi-structured interviews were conducted with 16 purposively recruited TAP participants. Participants were aware of their hepatitis C seropositive status and had received fibrosis assessment (measured by TE) prior to interview. Questions were open-ended, focusing on the impact of health status on wellbeing and self-reported stress. Interviews were voice recorded, transcribed verbatim and thematically analysed, guided by Mishel's (1988) theory of Uncertainty in Illness. RESULTS In line with Mishel's theory of Uncertainty in Illness all participants reported hepatitis C-related uncertainty, particularly mis-information or a lack of knowledge surrounding liver health and the meaning of TE results. Those with greater fibrosis experienced an extra layer of prognostic uncertainty. Experiences of uncertainty were a key motivation to seek treatment, which was seen as a way to regain some stability in life. Treatment completion alleviated hepatitis C-related stress, and promoted feelings of empowerment and confidence in addressing other life challenges. CONCLUSION TE scores seemingly provide some certainty. However, when paired with limited knowledge, particularly among people with severe fibrosis, TE may be a source of uncertainty and increased personal stress. This suggests the need for simple education programs and resources on liver health to minimise stress.
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Affiliation(s)
- Stelliana Goutzamanis
- Disease Elimination Program, Burnet Institute, 85 Commerical Rd, Melbourne, VIC, 3004, Australia. .,School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, 85 Commerical Rd, Melbourne, VIC, 3004, Australia.,Department of Infectious Diseases, Alfred Health, Melbourne, Australia
| | - Alexander Thompson
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Paul Dietze
- Disease Elimination Program, Burnet Institute, 85 Commerical Rd, Melbourne, VIC, 3004, Australia.,School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, 85 Commerical Rd, Melbourne, VIC, 3004, Australia.,School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Infectious Diseases, Alfred Health, Melbourne, Australia
| | - Peter Higgs
- Disease Elimination Program, Burnet Institute, 85 Commerical Rd, Melbourne, VIC, 3004, Australia.,School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Public Health, La Trobe University, Melbourne, Australia
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