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Int J Drug Policy. 2017 Sep;47:230-238. doi: 10.1016/j.drugpo.2017.05.040. Epub 2017 Jun 19.

Changes in risk behaviours during and following treatment for hepatitis C virus infection among people who inject drugs: The ACTIVATE study.

Author information

1
Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Norway; The Kirby Institute, UNSW Sydney, Australia; Department of Gastroenterology, Oslo University Hospital, Oslo, Norway. Electronic address: havardmi@medisin.uio.no.
2
The Kirby Institute, UNSW Sydney, Australia.
3
Vancouver Infectious Diseases Center, Vancouver, Canada.
4
Ludwig Maximilians-University Munich, Munich, Germany.
5
Arud Centres for Addiction Medicine, Zurich, Switzerland.
6
CHUM Research Center, Université de Montréal, Montreal, Canada.
7
Stuivenberg ZNA, Antwerp, Belgium.
8
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
9
The Liver Unit, Queen Mary University of London, London, United Kingdom.
10
Burnet Institute, Melbourne, Australia.
11
Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium; Department of Hepatology, UZ Leuven, Leuven, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Program, Hasselt University, Hasselt, Belgium.
12
Division of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland.
13
Nepean Hospital, Sydney, Australia.
14
The Kirby Institute, UNSW Sydney, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
15
Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Norway.

Abstract

BACKGROUND:

The risk of hepatitis C virus (HCV) reinfection due to continued injecting risk behaviours might remain a barrier to HCV treatment among people who inject drugs. We aimed to evaluate changes in risk behaviours during and following HCV treatment among people with ongoing injecting drug use or receiving opioid substitution treatment (OST).

METHODS:

ACTIVATE was an international multicentre clinical trial conducted between 2012 and 2014. Participants with HCV genotypes 2/3 infection were treated with peg-interferon/ribavirin for 12 or 24 weeks and completed a self-administered behavioural questionnaire at each study visit. The impact of time in treatment and follow-up on longitudinally measured recent (past month) behavioural outcomes was evaluated using generalized estimating equations.

RESULTS:

Among 93 enrolled participants (83% male, median age 41 years), 55 (59%) had injected in the past month. Any injecting drug use decreased during HCV treatment and follow-up (OR 0.89 per incremental study visit; 95% CI 0.83-0.95). No significant changes were found in ≥daily injecting (OR 0.98; 95% CI 0.89-1.07), use of non-sterile needles (OR 0.94; 95% CI 0.79-1.12), sharing of injecting paraphernalia (OR 0.87; 95% CI 0.70-1.07) or non-injecting drug use (OR 1.01; 95% CI 0.92-1.10). Hazardous alcohol use decreased throughout (OR 0.56; 95% CI 0.40-0.77) and OST increased between enrolment and end of treatment (OR 1.48; 95% CI 1.07-2.04).

CONCLUSIONS:

Recent injecting drug use and hazardous alcohol use decreased, while OST increased during and following HCV treatment among participants with ongoing injecting drug use. These findings support further expansion of HCV care among PWID.

KEYWORDS:

Alcohol use; Antiviral treatment; Hepatitis C virus; Injecting drug use; Opioid substitution treatment; People who inject drugs; Risk behaviours

PMID:
28633998
DOI:
10.1016/j.drugpo.2017.05.040
[Indexed for MEDLINE]

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