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Int J Drug Policy. 2017 Sep;47:239-243. doi: 10.1016/j.drugpo.2017.05.033. Epub 2017 Jun 4.

Short-term injection drug use changes following hepatitis C virus (HCV) assessment and treatment among persons who inject drugs with acute HCV infection.

Author information

1
Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis, Montréal, QC H2X 0A9, Canada.
2
Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis, Montréal, QC H2X 0A9, Canada.
3
School of Population Health, Division of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; Department of Medicine, St. Vincent's Hospital, The University of Melbourne, 29 Regent Street, Fitzroy, VIC 3065, Australia.
4
Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada.
5
Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada.
6
Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Côte-des-Neiges, Montréal, QC H3S 1Z1, Canada.
7
Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada. Electronic address: julie.bruneau@umontreal.ca.

Abstract

BACKGROUND:

It is unclear whether treatment and care for hepatitis C virus (HCV) infection can help people who inject drugs (PWID) modify their injection drug use behaviours. This study examined changes in injection drug use among PWID with acute HCV systematically referred for HCV clinical assessment and treatment and offered targeted health care services, over the course of one year.

METHODS:

The study sample included PWID with documented acute HCV infection recruited and followed-up semi-annually at least twice in IMPACT (2007-2015), a longitudinal community-based prospective study in Montréal, Canada. Following enrolment, participants with contra-indications to treatment due to severe co-morbidity were offered targeted health care services. Pegylated interferon-alpha (12-24 weeks) was offered to all other participants who did not spontaneously resolve their infection. At each study visit, data were collected on socio-demographic factors and drug use patterns. Logistic regression was used to assess changes in injection drug use at one-year follow-up.

RESULTS:

Of the 87 eligible participants (mean age: 35.6; 78.2% male), 21.8% received treatment [(RT), Sustained virological response: 84.2%], 25.3% spontaneously resolved their infection (SR), 14.9% had contra-indication(s) (CI) and 37.9% chose not to engage in HCV care post-diagnosis (NE). In multivariate analyses adjusting for age, gender and injection drug use at baseline, the RT [Adjusted odds ratio (AOR): 0.18; 95% Confidence interval (CI): 0.04-0.76], SR (AOR: 0.34; 95% CI: 0.08-1.40), and CI (AOR: 0.24; 95% CI: 0.05-1.22) groups were less likely to report injection drug use at follow-up relative to the NE group.

CONCLUSION:

PWID who received treatment, spontaneously resolved their infection or presented with treatment contra-indication(s) reported reduced injection drug use at one-year follow-up relative to those who did not engage in therapy. Findings suggest that the benefits of HCV assessment and treatment may extent to helping PWID modify their injection drug use patterns.

KEYWORDS:

Antiviral treatment; Cohort study; HCV; Hepatitis C care; Injection drug use; People who inject drugs

PMID:
28587944
DOI:
10.1016/j.drugpo.2017.05.033
[Indexed for MEDLINE]

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