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Abstract Details
The impact of current opioid agonist therapy on hepatitis C virus treatment initiation among people who use drugs from in the DAA era: A population-based study
Clin Infect Dis. 2021 Jun 14;ciab546. doi: 10.1093/cid/ciab546. Online ahead of print.
Sofia R Bartlett12, Stanley Wong1, Amanda Yu1, Margo Pearce13, Julia MacIsaac4, Susan Nouch56, Prince Adu13, James Wilton1, Hasina Samji17, Emilia Clementi13, Hector Velasquez1, Dahn Jeong13, Mawuena Binka1, Maria Alvarez1, Jason Wong13, Jane Buxton13, Mel Krajden12, Naveed Z Janjua13
Author information
1British Columbia Centre for Disease Control, Vancouver, BC, Canada.
2Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
3School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
4Division of Addiction Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
5Department of Family and Community Practice, Vancouver Coastal Health, Vancouver, BC, Canada.
6Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
7Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
Abstract
Background: Evidence that opioid agonist therapy (OAT) is associated with increased odds of hepatitis C virus (HCV) treatment initiation among people who use drugs (PWUD) is emerging. The objective of this study was to determine the association between current OAT and HCV treatment initiation among PWUD in a population-level linked administrative dataset.
Methods: The British Columbia (BC) Hepatitis Testers Cohort was used for this study, which includes all people tested for or diagnosed with HCV in BC, linked to medical visits, hospitalizations, laboratory, prescription drug, and mortality data from 1992 until 2019. PWUD with injecting drug use or opioid use disorder and chronic HCV infection were identified for inclusion in this study. HCV treatment initiation was the main outcome, and subdistribution proportional hazards modeling was used to assess the relationship with current OAT.
Results: 13,803 PWUD with chronic HCV were included in this study. Among those currently on OAT at the end of the study period, 47% (2,704/5,770) had started HCV treatment, whereas 22% (1778/8033) of those not currently on OAT has started HCV treatment .. Among PWUD with chronic HCV infection, current OAT was associated with higher likelihood of HCV treatment initiation in time to event analysis (adjusted hazard ratio 1.84 [95%CI, 1.50, 2.26]).
Conclusions: Current OAT was associated with a higher likelihood of HCV treatment initiation. However, many PWUD with HCV currently receiving OAT have yet to receive HCV treatment. Enhanced integration between substance use care and HCV treatment is needed to improve the overall health of PWUD.