High levels of all-cause mortality among people who inject drugs from 2018 to 2022

International Journal of Drug Policy, Journal Year: 2024, Volume and Issue: 126, P. 104356 - 104356

Published: Feb. 23, 2024

Language: Английский

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The impact of homelessness and housing insecurity on HIV

The Lancet HIV, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

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HCV Cascade of Care in HIV/HCV Co-Infected Individuals: Missed Opportunities for Micro-Elimination

Viruses, Journal Year: 2024, Volume and Issue: 16(6), P. 885 - 885

Published: May 30, 2024

People living with HIV-HCV co-infection comprise a target group for HCV-micro-elimination. We conducted an HCV cascade of care (CoC) co-infected individuals in Greece and investigated factors associated different HCV-CoC stages. analyzed data from 1213 participants the Athens Multicenter AIDS Cohort Study. A seven-stage CoC, overall by subgroup (people who inject drugs (PWID), men having sex (MSM), women (MSW), migrants], was constructed, spanning diagnosis to sustained virologic response (SVR). Logistic/Cox regression models were employed identify passing through each CoC step. Among 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 underwent HCV-RNA testing. Migrants showed lowest retention rates. available 79.2% those care, 77.8% diagnosed chronic HCV. Subsequently, 71% initiated DAAs, very low CD4 counts (<100 cells/μL) exhibiting lower odds DAA initiation. SVR testing 203 85.7% achieving SVR. The did not differ across risk groups. In 2023, significant gaps between-group differences persisted among Greece.

Language: Английский

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Closing doors, opening windows – Adaptations and opportunities for harm reduction services during the COVID-19 pandemic in Europe

Drugs Education Prevention and Policy, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 12

Published: June 5, 2024

Background Across Europe, harm reduction services experienced significant disruptions during the COVID-19 pandemic. This study analyses experiences of service providers pandemic in 34 European cities, focusing on their main challenges, adaptations, and opportunities for change. A closer examination Athens Dublin offers an in-depth look into these experiences.

Language: Английский

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HCV‐HIV co‐infection in people who inject drugs: Barriers to treatment and cure of HCV infection in the era of DAAs, a prospective study in Athens, Greece

HIV Medicine, Journal Year: 2024, Volume and Issue: 25(10), P. 1135 - 1144

Published: June 20, 2024

Abstract Objectives HIV/hepatitis C virus (HCV) co‐infection among people who inject drugs (PWID) remains a global health problem. The goal of our study was to evaluate, in real‐world setting, success rates sustained virological response (SVR) using direct‐acting antivirals (DAAs) treat population PWID living with HCV/HIV. Methods This prospective single‐center observational study. We collected demographic, socioeconomic, and clinical data pertaining HIV HCV infection several barriers care. identified risk factors for SVR failure. Results Among 130 individuals retained care, we planned treatment 119/130 (91.5%); 106/119 (89.1%) started DAAs 100/106 (94.3%) completed treatment. People not starting were more often active opioid drug use (odds ratio [OR] 0.25; 95% confidence interval [CI] 0.07–0.97, p = 0.045) benzodiazepine abuse (OR CI 0.07–0.95, 0.042). Only 86/100 (86%) tested at 12 weeks (SVR12) 72/86 (83.7%) achieved SVR. substitution programmes tended return SVR12 testing (54.7% vs. 30%, 0.081). Individuals 0.226; 0.064–0.793, 0.02) or poor adherence 0.187; 0.043–0.814, 0.025) less likely achieve At the end period, 113/119 (95%) treatment‐eligible patients remained alive. cured 68/113 (61.1%) people. Conclusions Our findings underscore importance prioritizing combatting substance elimination goals. A systematic approach effort overcome receiving completing encourage enrol if possible completely abstain from use, can help increase chances cure.

Language: Английский

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Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021

Eurosurveillance, Journal Year: 2024, Volume and Issue: 29(48)

Published: Nov. 28, 2024

Background Late HIV diagnosis (CD4 + T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing. Aim To determine the frequency of indicator conditions (ICs) preceding and to quantify MOs testing at nationwide level Greece. Methods This multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed during 2019–21. Medical records were reviewed identify pre-diagnosis healthcare contacts (HCCs) ICs justifying Univariable multivariable logistic regression identified factors associated ≥ 1 MO. A Bayesian model estimated time from seroconversion diagnosis. Results Among 517 participants HCC data, 249 had HCC. Of these, 59.0% (147/249) late presenters. These cases 365 HCCs, 191 (52.3%) The most common sexually transmitted infections (39.8%; 76/191) fever (11.0%; 21/191). Non-Greek origin was lower odds experiencing MO (adjusted ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased early Median 3.2 years full sample 3.7 those HCC, about half latter reporting post-estimated seroconversion. Recognising would have potentially spared approximately year delay Conclusion prevalent Leveraging IC-guided addressing barriers could support treatment, limiting adverse health outcomes preventing transmission.

Language: Английский

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Molecular epidemiology of HIV among people who inject drugs after the HIV-outbreak in Athens, Greece: Evidence for a ‘slow burn’ outbreak

Infection Genetics and Evolution, Journal Year: 2024, Volume and Issue: 121, P. 105597 - 105597

Published: April 23, 2024

New diagnoses of HIV-1 infection among people who inject drugs (PWID) in Athens, Greece, saw a significant increase 2011 and subsequent decline after 2013. Despite this, ongoing transmission persisted from 2014 to 2020 within this population. Our objective was estimate the time for PWID Athens following outbreak, explore patterns dispersal over time, determine duration diagnosis. Time diagnosis estimated 844 individuals infected 4 PWID-specific clusters 8 with sub-subtype A6 diagnosed during 2010–2019. Phylogeny reconstruction performed using maximum-likelihood method. dates were based on molecular clock calculations. In total 86 92 (93.5%) sequences 2016–2019 either related previously identified (n = 81) or belonged new cluster 5). The median between 0.42 years outbreak period 0.70 (p < 0.001). proportion clustered very low at 5.3% pre-outbreak (1998–2009), an 41.7% one year before 2010, consistently remained high whole 2011, spanning post-outbreak (2016–2019) range 92.9% 100%. substantial infections implies persistent 'slow burn' HIV suggesting that not successfully eliminated. since onset suggests persistence attributed injection practices. findings underscore importance targeted interventions PWID, considering rate prolonged

Language: Английский

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Incidence of primary hepatitis C infection among people who inject drugs during 2012–2020 in Athens, Greece

Journal of Viral Hepatitis, Journal Year: 2024, Volume and Issue: 31(8), P. 466 - 476

Published: May 14, 2024

Abstract One of the World Health Organization's targets for 2030 viral hepatitis elimination strategy is to reduce new C (HCV) infections. In Athens, Greece, people who inject drugs (PWID) have a high HCV prevalence, with increasing trends since 2000s. This analysis aims assess primary incidence among PWID during 2012–2020. Two community‐based interventions were implemented in 2012–2013 and 2018–2020 repeated sero‐behavioural surveys each period. Participants enrolled multiple identified through linkage. To transmission, three indicators estimated: (i) anti‐HCV prevalence ‘new’ injectors (those injecting ≤2 years), (ii) indirect injectors, assuming infection occurred at midpoint between initiating injection first positive test, (iii) from repeat participants. There 431 125 respectively, 2018–2020. Αnti‐HCV [95% CI] declined 53.6% [48.8%, 58.3%] 40.0% [31.3, 49.1%] (25.4% reduction, p = .007). The estimate decreased 56.1 [49.3, 63.8] 39.0/100 person‐years (PYs) [29.6, 51.5] (30.5% .020). based on seroconversions participants (16/63 9/55 2018–2020) 64.6 [39.6105.4] 13.8/100 PYs [7.2, 26.5], respectively (78.6% < .001). Primary remains Athens. Consistent implementation combined interventions, including high‐coverage harm reduction programs initiatives tailored increase access treatment, essential sustain declining documented

Language: Английский

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Impact of Pandemic-Induced Service Disruptions and Behavioral Changes on Hepatitis C Virus and HIV Transmission Amongst People Who Inject Drugs: A Modeling Study

The Journal of Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 5, 2024

The COVID-19 pandemic may have disproportionally impacted vulnerable groups such as people who inject drugs (PWID) through reduced healthcare services well social changes from mitigation measures. Understanding how the and associated strategies subsequently changed trajectory of hepatitis C virus (HCV) HIV transmission is critical to estimating disease burdens, identifying outbreak risk, developing informed intervention strategies.

Language: Английский

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Trends in COVID-19 testing, infection, vaccination, and housing assistance among people who inject drugs in Los Angeles and Denver

Journal of Substance Use, Journal Year: 2023, Volume and Issue: unknown, P. 1 - 7

Published: Dec. 7, 2023

Introduction We examined COVID-19 trends and the socio-structural correlates of infections vaccinations among people who inject drugs (PWID).

Language: Английский

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