Emmanuel Fortier1, Maryam Alavi, Julie Bruneau, Michelle Micallef, Jacinta Perram, Sanjeev Sockalingam, Adrian J Dunlop, Annie C Balcomb, Carolyn A Day, Carla Treloar, Nicky Bath, Paul S Haber, Gregory J Dore, Jason Grebely. 1. Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal (EF, JB); CHUM Research Center, Centre Hospitalier de l'Université de Montréal, Montréal (EF, JB), QC, Canada; The Kirby Institute, UNSW Australia, Sydney, NSW, Australia (EF, MA, MM, GJD, JG); St. Vincent's Hospital, Sydney, NSW, Australia (JP); Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada (SS); University of Newcastle (AJD); Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle (AJD); Clinic 96, Kite St Community Health Centre, Orange (ACB); Drug Health Service, Royal Prince Alfred Hospital (CAD, PSH); Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney (CAD); Centre for Social Research in Health, UNSW Australia (CT); NSW Health (NB); Sydney Medical School, University of Sydney (PSH), Sydney, NSW, Australia.
Abstract
OBJECTIVE: The aims of this study were to assess symptoms of depression, anxiety, and stress and associated sociodemographic factors among people living with chronic hepatitis C virus (HCV) infection with a history of injecting drug use and to assess the association between symptoms of depression, anxiety, or stress and HCV treatment intent, specialist assessment, or treatment uptake. METHODS: The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings was an observational cohort study evaluating the provision of HCV assessment and treatment among people with chronic HCV and a history of injecting drug use, recruited from 9 community health centers and opioid substitution therapy (OST) clinics (New South Wales, Australia). Symptoms were assessed using the Depression Anxiety Stress Scales (DASS-21). Analyses were performed using logistic regression. RESULTS: Among 415 participants (mean age 41 years, 71% male), 47%, 52%, and 36% demonstrated moderate to extremely severe symptoms of depression, anxiety, and stress, respectively. In adjusted analyses, depression symptoms were associated with recent injecting drug use [adjusted odds ratio (aOR) 1.63, 95% confidence interval (CI) 1.07-2.49), whereas stress symptoms were associated with unemployment (aOR 2.99, 95% CI 1.09-8.15) and not living with a spouse or other relatives/friends (aOR 1.55, 95% CI 1.01-2.39). Symptoms of depression, anxiety, or stress or having a history of treated mental illness were not independently associated with HCV treatment intent, specialist assessment, or treatment uptake. CONCLUSIONS: Findings suggest a need for improved interventions and care regarding mental health among people living with chronic HCV with a history of injecting drug use, but suggest that symptoms of depression, anxiety, and stress should not be immediate contraindications to HCV assessment and treatment.
OBJECTIVE: The aims of this study were to assess symptoms of depression, anxiety, and stress and associated sociodemographic factors among people living with chronic hepatitis C virus (HCV) infection with a history of injecting drug use and to assess the association between symptoms of depression, anxiety, or stress and HCV treatment intent, specialist assessment, or treatment uptake. METHODS: The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings was an observational cohort study evaluating the provision of HCV assessment and treatment among people with chronic HCV and a history of injecting drug use, recruited from 9 community health centers and opioid substitution therapy (OST) clinics (New South Wales, Australia). Symptoms were assessed using the Depression Anxiety Stress Scales (DASS-21). Analyses were performed using logistic regression. RESULTS: Among 415 participants (mean age 41 years, 71% male), 47%, 52%, and 36% demonstrated moderate to extremely severe symptoms of depression, anxiety, and stress, respectively. In adjusted analyses, depression symptoms were associated with recent injecting drug use [adjusted odds ratio (aOR) 1.63, 95% confidence interval (CI) 1.07-2.49), whereas stress symptoms were associated with unemployment (aOR 2.99, 95% CI 1.09-8.15) and not living with a spouse or other relatives/friends (aOR 1.55, 95% CI 1.01-2.39). Symptoms of depression, anxiety, or stress or having a history of treated mental illness were not independently associated with HCV treatment intent, specialist assessment, or treatment uptake. CONCLUSIONS: Findings suggest a need for improved interventions and care regarding mental health among people living with chronic HCV with a history of injecting drug use, but suggest that symptoms of depression, anxiety, and stress should not be immediate contraindications to HCV assessment and treatment.
Authors: Irene Pericot-Valverde; Moonseong Heo; Jiajing Niu; Brianna L Norton; Matthew J Akiyama; Linda Agyemang; Alain H Litwin Journal: Open Forum Infect Dis Date: 2020-10-10 Impact factor: 3.835