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Abstract Details
Hepatitis C cure and medications for opioid use disorder improve health-related quality of life in patients with opioid use disorder actively engaged in substance use
Int J Drug Policy. 2022 Nov 13;111:103906. doi: 10.1016/j.drugpo.2022.103906.Online ahead of print.
1Department of Psychiatry, University of Maryland School of Medicine, 110 South Paca Street 4(th) Floor, Baltimore, Maryland 21201, United States. Electronic address: mspaderna@som.umaryland.edu.
2Department of Psychiatry, University of Maryland School of Medicine, 110 South Paca Street 4(th) Floor, Baltimore, Maryland 21201, United States; Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, Maryland 21201, United States; DC Partnership for HIV/AIDS Progress, Clinical Research Program, Washington, District of Columbia, United States.
3Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, Maryland 20892, United States.
4Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, Maryland 21201, United States.
5HIPS, 906 H Street NE, Washington, District of Columbia 20002, United States.
6Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, Maryland 21201, United States; DC Partnership for HIV/AIDS Progress, Clinical Research Program, Washington, District of Columbia, United States.
7DC Partnership for HIV/AIDS Progress, Clinical Research Program, Washington, District of Columbia, United States; Critical Care Medicine Department, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, Maryland 20892, United States.
8Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, 6001 Executive Boulevard, Room 6200, Bethesda, Maryland 20892, United States.
Abstract
Background: This study aims to determine whether Hepatitis C (HCV) treatment improves health-related quality of life (HRQL) in patients with opioid use disorder (OUD) actively engaged in substance use, and which variables are associated with improving HRQL in patients with OUD during HCV treatment.
Methods: Data are from a prospective, open-label, observational study of 198 patients with OUD or opioid misuse within 1 year of study enrollment who received HCV treatment with the primary endpoint of Sustained Virologic Response (SVR). HRQL was assessed using the Hepatitis C Virus Patient Reported Outcomes (HCV-PRO) survey, with higher scores denoting better HRQL. HCV-PRO surveys were conducted at Day 0, Week 12, and Week 24. A mixed-effects model investigated which variables were associated with changing HCV-PRO scores from Day 0 to Week 24.
Results: Patients had a median age of 57 and were predominantly male (68.2%) and Black (83.3%). Most reported daily-or-more drug use (58.6%) and injection drug use (IDU) (75.8%). Mean HCV-PRO scores at Day 0 and Week 24 were 64.0 and 72.9, respectively. HCV-PRO scores at Week 24 improved compared with scores at Day 0 (8.7; p<0.001). Achieving SVR (10.4; p<0.001) and receiving medications for OUD (MOUD) at Week 24 (9.5; p<0.001) were associated with improving HCV-PRO scores. HCV-PRO scores increased at Week 24 for patients who experienced no decline in IDU frequency (8.1; p<0.001) or had a UDS positive for opioids (8.0; p<0.001) or cocaine (7.5; p=0.003) at Week 24.
Conclusion: Patients with OUD actively engaged in substance use experience improvement in HRQL from HCV cure unaffected by ongoing substance use. Interventions to promote HCV cure and MOUD engagement could improve HRQL for patients with OUD.