Monitoring hepatitis C virus treatment rates in an Opioid Treatment Program : A longitudinal study
Sanvisens, Arantza (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rivas, Inmaculada (Badalona Serveis Assistencials)
Faure, Eva (Badalona Serveis Assistencials)
Espinach, Néstor (Badalona Serveis Assistencials)
Hernandez-Rubio, Anna (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Majó, Xavier (Servei Català de la Salut)
Colom, Joan (Colom Farran) (Servei Català de la Salut)
Muga, Roberto (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Direct-acting antivirals (DAAs) are recommended for the treatment of hepatitis C virus (HCV) infection in patients treated with methadone or buprenorphine. To assess HCV treatment rates in an Opioid Treatment Program (OTP). This longitudinal study included 501 patients (81. 4% men, median age: 45 years; interquartile range: 39-50 years) enrolled in an OTP between October 2015 and September 2017. Patients were followed until September 2019. Data on socio-demographics, substance use, HCV infection, human immunodeficiency virus (HIV) infection and laboratory parameters were collected at entry. We analyzed medical records to evaluate HCV treatment. Kaplan-Meier methods and Cox regression models were used to analyze the DAA treatment uptake and to identify treatment predictors. Prevalence of HCV and HIV infection was 70% and 34%, respectively. Among anti-HCV-positive (n = 336) patients, 47. 2%, 41. 3%, and 31. 9% used alcohol, cannabis, and cocaine, respectively. HCV-RNA tests were positive in 233 (69. 3%) patients. Twentyeight patients (8. 3%) cleared the infection, and 59/308 (19. 1%) had received interferon-based treatment regimens before 2015. Among 249 patients eligible, 111 (44. 6%) received DAAs. Treatment rates significantly increased over time from 7. 8/100 person-years (p-y) (95%CI: 5. 0-12. 3) in 2015 to 18. 9/100 p-y (95%CI: 11. 7-30. 3) in 2019. In a multivariate analysis, patients with HIV co-infection were twice as likely to receive DAAs (HR = 1. 94, 95%CI: 1. 21-3. 12) than patients with HCV mono-infection. Current drug use was an independent risk factor for not receiving treatment against infection (HR = 0. 48, 95%CI: 0. 29-0. 80). HCV treatment is evolving in patients with HCV-HIV co-infection. Ongoing drug use while in an OTP might negatively impact the readiness to treat infection.
Ajuts:	Ministerio de Economía y Competitividad RD16/0017/0003 Instituto de Salud Carlos III PI17/00174 Instituto de Salud Carlos III INT19/00026 Instituto de Salud Carlos III CD19/00019 European Commission 806996 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017SGR316
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Estudi clínic ; recerca ; Versió publicada
Matèria:	Direct-acting antiviral agents ; Opioid Treatment Program ; Opioid agonist therapy ; Hepatitis C virus infection ; Human immunodeficiency virus infection ; Drug use
Publicat a:	World Journal of Gastroenterology, Vol. 26 Núm. 38 (october 2020) , p. 5874-5883, ISSN 2219-2840

DOI: 10.3748/wjg.v26.i38.5874
PMID: 33132641

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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