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Objective: To evaluate the feasibility of testing and treating people who inject drugs at a supervised injecting facility for hepatitis C virus (HCV) infection. Design: Retrospective cohort study. Setting, participants: People who inject drugs who attended the Melbourne supervised injecting facility, 30 June 2018 – 30 June 2020. Main outcome measures: Proportion of people tested for hepatitis C; proportions of people positive for anti‐HCV antibody and HCV RNA, and of eligible people prescribed direct‐acting antiviral (DAA) treatment; sustained virological response twelve weeks or more after treatment completion. Results: Of 4649 people who attended the supervised injecting facility during 2018–20, 321 were tested for hepatitis C (7%); 279 were anti‐HCV antibody‐positive (87%), of whom 143 (51%) were also HCV RNA‐positive. Sixty‐four of 321 had previously been treated for hepatitis C (20%), 21 had clinically identified cirrhosis (7%), eight had hepatitis B infections (2%), and four had human immunodeficiency virus infections (1%). In multivariate analyses, people tested for hepatitis C were more likely than untested clients to report psychiatric illness (adjusted odds ratio [aOR], 9.65; 95% confidence interval [CI], 7.26–12.8), not have a fixed address (aOR, 1.59; 95% CI, 1.18–2.14), and to report significant alcohol use (aOR, 1.57; 95% CI, 1.06–2.32). The median number of injecting facility visits was larger for those tested for hepatitis C (101; interquartile range [IQR], 31–236) than for those not tested (20; IQR, 3–90). DAA treatment was prescribed for 126 of 143 HCV RNA‐positive clients (88%); 41 of 54 with complete follow‐up data were cured (76%). Conclusions: People who attend supervised injecting facilities can be tested and treated for hepatitis C on site. Models that provide streamlined, convenient hepatitis C care promote engagement with treatment in a group in which the prevalence of hepatitis C is high. [ABSTRACT FROM AUTHOR]

Few reports exist of disseminated histoplasmosis in patients with dermatomyositis, with most already receiving immunosuppressive therapy at the time of presentation.[5] Disseminated histoplasmosis partially mimicking a dermatomyositis in a patient with rheumatoid arthritis. [Extracted from the article]

Background: Prisons provide a key strategic opportunity to upscale hepatitis C testing and treatment in a high prevalence setting and are crucial for elimination efforts., Methods: A decentralized, statewide nurse-led model of care offering hepatitis C treatment for people in prison was implemented in Victoria, Australia in 2015. The program provides hepatitis C care to all 14 adult prison sites in the jurisdiction. We prospectively evaluated treatment uptake between 1 November 2015 and 31 December 2021. Data on all people in prison treated were recorded in a clinical database. The primary outcomes were i) total number of people in prison with hepatitis C treated; ii) total number of DAA treatment courses., Results: 3,133 DAA treatment courses were prescribed to 2,768 people in prison. The proportion of total Victoria DAA prescriptions the program was responsible for increased from 6% in 2016 to a peak of 23% in 2020. Of those treated, median age was 39 years, 91% were male and 9% had cirrhosis. Few (20%) had previously engaged in hepatitis C care in the community and at first treatment course in prison, only 6% had previously accessed hepatitis C treatment. Complete follow up data were available for 1,757/2,768 (63%) treated, with 1,627/1,757 (93%) achieving SVR12., Conclusions: A decentralized, nurse-led, statewide model of care was highly effective in treating large numbers of people in prison with hepatitis C and achieved high rates of SVR12. Nurse-led prison programs are playing a crucial role in eliminating hepatitis C as a public health threat in Australia., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Victims of interpersonal violence are known to be at increased risk of suicidal ideation and attempts; however, few data exist on the impact that violence has on the risk of death from suicide. This study examined 2153 suicides (1636 males and 517 females) occurring between 2009 and 2012. Information was sourced from the Coroners Court of Victoria's Suicide Register, a detailed database containing information on all Victorian suicides. Forty-two percent of women who died from suicide had a history of exposure to interpersonal violence, with 23% having been a victim of physical violence, 18% suffering psychological violence, and 16% experiencing sexual abuse. A large number of men who died from suicide had also been exposed to interpersonal violence, many of whom had perpetrated violence within the 6 weeks prior to their death. Targeted prevention, particularly removing barriers for men to seek help early after perpetrating violence is likely to have benefits in preventing suicide in both men and women.