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Abstract Details
The Relationship Between Hepatitis C Virus Rates and Office-Based Buprenorphine Access in Ohio
Open Forum Infect Dis. 2021 May 17;8(6):ofab242. doi: 10.1093/ofid/ofab242.eCollection 2021 Jun.
Daniel L Brook12, Angela T Hetrick1, Shibani R Chettri1, Christine A Schalkoff3, Adams L Sibley3, Kathryn E Lancaster1, Vivian F Go3, William C Miller1, David M Kline4
Author information
1Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA.
2Medical Scientist Training Program, The Ohio State University College of Medicine, Columbus, Ohio, USA.
3Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
4Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Abstract
Background: The United States is experiencing an epidemic of hepatitis C virus (HCV) infections due to injection drug use, primarily of opioids and predominantly in rural areas. Buprenorphine, a medication for opioid use disorder, may indirectly prevent HCV transmission. We assessed the relationship of HCV rates and office-based buprenorphine prescribing in Ohio.
Methods: We conducted an ecological study of the county-level (n = 88) relationship between HCV case rates and office-based buprenorphine prescribing in Ohio. We fit adjusted negative binomial models between the county-level acute and total HCV incidence rates during 2013-2017 and 1) the number of patients in each county that could be served by office-based buprenorphine (prescribing capacity) and 2) the number served by office-based buprenorphine (prescribing frequency) from January-March, 2018.
Results: For each 10% increase in acute HCV rate, office-based buprenorphine prescribing capacity differed by 1% (95% CI: -1%, 3%). For each 10% increase in total HCV rate, office-based buprenorphine prescribing capacity was 12% (95% CI: 7%, 17%) higher. For each 10% increase in acute HCV rate, office-based buprenorphine prescribing frequency was 1% (95% CI: -1%, 3%) higher. For each 10% increase in total HCV rate, office-based buprenorphine prescribing frequency was 14% (95% CI: 7%, 20%) higher.
Conclusions: Rural counties in Ohio have less office-based buprenorphine and higher acute HCV rates versus urban counties, but a similar relationship between office-based buprenorphine prescribing and HCV case rates. To adequately prevent and control HCV rates, certain rural counties may need more office-based buprenorphine prescribing in areas with high HCV case rates.