Maryam Alavi1, Tim Spelman2, Gail V Matthews3, Paul S Haber4, Carolyn Day5, Ingrid van Beek6, Nick Walsh7, Barbara Yeung3, Julie Bruneau8, Kathy Petoumenos3, Kate Dolan9, John M Kaldor3, Gregory J Dore3, Margaret Hellard2, Jason Grebely3. 1. The Kirby Institute, UNSW Australia, Sydney, Australia. Electronic address: msalehialavi@kirby.unsw.edu.au. 2. Burnet Institute, Melbourne, Australia. 3. The Kirby Institute, UNSW Australia, Sydney, Australia. 4. Drug Health Services, Central Clinical School (C39), University of Sydney, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia. 5. Central Clinical School, University of Sydney, Sydney, Australia. 6. Kirketon Road Centre, Sydney, Australia. 7. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 8. Centre de Recherche, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada. 9. National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: A barrier to hepatitis C virus (HCV) treatment among people who inject drugs (PWID) has been a concern that interferon-based HCV treatment may increase injecting risk behaviours. This study evaluated recent (past month) injecting risk behaviours during follow-up among PWID that did and did not receive HCV treatment. METHODS: The Australian Trial in Acute Hepatitis C (ATAHC) was a prospective study of natural history and treatment of recent HCV infection. Analyses were performed using generalized estimating equations. RESULTS: Among 124 participants with a history of injecting drug use (median age 32 years), 69% were male, and 68% were treated for HCV infection. HCV treatment was not associated with an increase in recent injecting drug use (adjusted odds ratio (aOR) 1.06, 95% CI 0.93, 1.21) or recent used needle and syringe borrowing during follow-up (aOR 0.99, 95% CI 0.89, 1.08). HCV treatment was associated with a decrease in recent ancillary injecting equipment sharing during follow-up (aOR 0.85, 95% CI 0.74, 0.99). Further, among treated participants who remained in follow-up (n=24), ancillary injecting equipment sharing significantly decreased from 54% at enrolment to 17% during follow-up (P=0.012). CONCLUSIONS: HCV treatment was not associated with drug use or used needle and syringe borrowing during follow-up, but was associated with decreased ancillary injecting equipment sharing during follow-up. Programs to enhance HCV assessment and treatment among PWID should be expanded, given that HCV treatment does not lead to increases in injecting risk behaviours and has previously been demonstrated to be safe and effective among PWID.
BACKGROUND: A barrier to hepatitis C virus (HCV) treatment among people who inject drugs (PWID) has been a concern that interferon-based HCV treatment may increase injecting risk behaviours. This study evaluated recent (past month) injecting risk behaviours during follow-up among PWID that did and did not receive HCV treatment. METHODS: The Australian Trial in Acute Hepatitis C (ATAHC) was a prospective study of natural history and treatment of recent HCV infection. Analyses were performed using generalized estimating equations. RESULTS: Among 124 participants with a history of injecting drug use (median age 32 years), 69% were male, and 68% were treated for HCV infection. HCV treatment was not associated with an increase in recent injecting drug use (adjusted odds ratio (aOR) 1.06, 95% CI 0.93, 1.21) or recent used needle and syringe borrowing during follow-up (aOR 0.99, 95% CI 0.89, 1.08). HCV treatment was associated with a decrease in recent ancillary injecting equipment sharing during follow-up (aOR 0.85, 95% CI 0.74, 0.99). Further, among treated participants who remained in follow-up (n=24), ancillary injecting equipment sharing significantly decreased from 54% at enrolment to 17% during follow-up (P=0.012). CONCLUSIONS: HCV treatment was not associated with drug use or used needle and syringe borrowing during follow-up, but was associated with decreased ancillary injecting equipment sharing during follow-up. Programs to enhance HCV assessment and treatment among PWID should be expanded, given that HCV treatment does not lead to increases in injecting risk behaviours and has previously been demonstrated to be safe and effective among PWID.
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