Opioid agonist treatment programs and hepatitis C virus elimination in Taiwan: Ways of expanding the care cascade in screening and treatment

Yu-Chu Ella Chung; Ching-Ing Tseng; Sheng-Chang Wang; Chieh-Liang Huang; Lian-Yu Chen; Raoh-Fang Pwu; Ching-Ching Claire Lin; An-Nie Chung; Jing-Shu Lin; Wei J Chen

doi:10.1016/j.drugpo.2024.104658

Opioid agonist treatment programs and hepatitis C virus elimination in Taiwan: Ways of expanding the care cascade in screening and treatment

Int J Drug Policy. 2024 Nov 13:134:104658. doi: 10.1016/j.drugpo.2024.104658. Online ahead of print.

Authors

Affiliations

¹ Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan.
² Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan.
³ Department of Mental Health, Ministry of Health and Welfare, Taipei, Taiwan.
⁴ Data Science Center, Fu Jen Catholic University, Taipei, Taiwan.
⁵ Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁶ Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan. Electronic address: wjchen@ntu.edu.tw.

PMID: 39541763
DOI: 10.1016/j.drugpo.2024.104658

Abstract

Background: One key population related to achieving the global goal of hepatitis C virus (HCV) elimination is people who inject drugs (PWID). By surveying opioid agonist treatment (OAT) programs nationwide in Taiwan, this study aimed to examine (1) the current status of HCV care cascade provision by OAT programs and (2) the opinions of the programs' directors on integrating the HCV care cascade into OAT programs.

Methods: From September to November 2022, questionnaires were sent via administrative networks to case managers for information on daily operation and routine booking and to directors for information on the HCV care cascade of 185 OAT programs. The responses of the 125 OAT programs that provided information from both case managers and directors were included for subsequent analyses.

Results: Among the 125 OAT programs, 91 (73 %) offered HCV antibody testing, and 69 (55 %) offered HCV treatment services. The provision of HCV antibody testing was associated with being general hospital- or psychiatric hospital-based and having more care team personnel, whereas the provision of HCV treatment was associated with being general hospital-based. However, on-site HCV treatment was found to be rarely offered, and the future willingness to do so remained low.

Conclusion: Our survey revealed that the provision of HCV screening and treatment in OAT programs in Taiwan has substantial room for improvement. Increasing the number of care personnel for satellite-dispensing OAT programs is key to expanding the service for HCV screening, as more issues related to multidisciplinary medical resources are involved in the provision of HCV treatment. Our results point to some options that might help accomplish these goals.

Keywords: Care cascade; HCV antibody testing; HCV treatment; Hepatitis C virus; Opioid agonist treatment; People who inject drugs.