Journal Article

Future destinations: how people cured of hepatitis C using direct acting antiviral drugs progress in a new HCV-free world. A thematic analysis

Radley, Andrew, Dillon, John F., Donaldson, Sarah R.

2025

Overview

Background The introduction of Direct-Acting Antivirals (DAAs) transformed Hepatitis C (HCV) treatment, despite this uptake of DAAs remains lower than required to meet the WHO Sustainable Development Goal (3.3). Treatment with interferon was suggested to be able to deliver important outcomes for people who use drugs in addition to a viral cure, such as social redemption, and shift from a stigmatised identity. There is a lack of understanding if DAAs can deliver these transformative outcomes. Methods This recurrent cross-sectional study combines qualitative semi-structured interviews and demographic data of 15 participants receiving DAAs in Tayside, Scotland. A thematic analysis explored the non-clinical outcomes of DAA treatment viewed through the lens of the Social Identity Model of Recovery (SIMOR) to build understanding of the influence DAAs have in a recovery journey from drug use. Results Three key themes emerged: identity, relationships and social networks; building recovery capital; and reflecting on re-infection and the shift to DAAs. Concern about the transmission of HCV resulted in self-imposed isolation which weakened support structures. Cure provides a mechanism to strengthen family bonds, however social networks in the wider community remain limited. Participants gained opportunities to undertake activities that build health and wellbeing providing a shift in identity, future plans and aspirations. Social isolation remained for some, revealing unmet need in post-cure support. Conclusion DAAs may support recovery journeys through the SIMOR, individuals reduced the number of active users within their social network and reconnected with family members, building recovery capital. Individuals, however, remained socially isolated in the context of the wider community. HCV services should support links to community resources to deliver the social inclusion people desire.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Antiviral agents / Antiviral Agents - therapeutic use / Antiviral drugs / Clinical outcomes / COVID-19 / Cross-Sectional Studies / Demographics / Direct-Acting Antivirals / Disease transmission / Dosage and administration / Drug addicts / Drug therapy / Drug use / Drugs / Female / Health aspects / Health Promotion and Disease Prevention / Health Psychology / Hepatitis / Hepatitis C / Hepatitis C - drug therapy / Hepatitis C, Chronic - drug therapy / Humans / Identity / Inclusion / Interferon / Male / Medicine / Medicine & Public Health / Middle Aged / Patient outcomes / Prevention / Qualitative analysis / Qualitative Research / Recovery / Scotland / Social identity / Social interactions / Social networks / Social organization / Social Policy / Social Support / Social Work / Sustainable development / Well being