Sofia R Bartlett1,2, Stanley Wong1, Amanda Yu1, Margo Pearce1,3, Julia MacIsaac4, Susan Nouch5,6, Prince Adu1,3, James Wilton1, Hasina Samji1,7, Emilia Clementi1,3, Hector Velasquez1, Dahn Jeong1,3, Mawuena Binka1, Maria Alvarez1, Jason Wong1,3, Jane Buxton1,3, Mel Krajden1,2, Naveed Z Janjua1,3. 1. British Columbia Centre for Disease Control, Vancouver, BC, Canada. 2. Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 3. School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 4. Division of Addiction Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 5. Department of Family and Community Practice, Vancouver Coastal Health, Vancouver, BC, Canada. 6. Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 7. Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
Abstract
BACKGROUND: Evidence that opioid agonist therapy (OAT) is associated with increased odds of hepatitis C virus (HCV) treatment initiation among people who use drugs (PWUD) is emerging. The objective of this study was to determine the association between current OAT and HCV treatment initiation among PWUD in a population-level linked administrative dataset. METHODS: The British Columbia Hepatitis Testers Cohort was used for this study, which includes all people tested for or diagnosed with HCV in British Columbia, linked to medical visits, hospitalizations, laboratory, prescription drug, and mortality data from 1992 until 2019. PWUD with injecting drug use or opioid use disorder and chronic HCV infection were identified for inclusion in this study. HCV treatment initiation was the main outcome, and subdistribution proportional hazards modeling was used to assess the relationship with current OAT. RESULTS: In total, 13 803 PWUD with chronic HCV were included in this study. Among those currently on OAT at the end of the study period, 47% (2704/5770) had started HCV treatment, whereas 22% (1778/8033) of those not currently on OAT had started HCV treatment. Among PWUD with chronic HCV infection, current OAT was associated with higher likelihood of HCV treatment initiation in time to event analysis (adjusted hazard ratio 1.84 [95% confidence interval {CI}, 1.50, 2.26]). CONCLUSIONS: Current OAT was associated with a higher likelihood of HCV treatment initiation. However, many PWUD with HCV currently receiving OAT have yet to receive HCV treatment. Enhanced integration between substance use care and HCV treatment is needed to improve the overall health of PWUD.
BACKGROUND: Evidence that opioid agonist therapy (OAT) is associated with increased odds of hepatitis C virus (HCV) treatment initiation among people who use drugs (PWUD) is emerging. The objective of this study was to determine the association between current OAT and HCV treatment initiation among PWUD in a population-level linked administrative dataset. METHODS: The British Columbia Hepatitis Testers Cohort was used for this study, which includes all people tested for or diagnosed with HCV in British Columbia, linked to medical visits, hospitalizations, laboratory, prescription drug, and mortality data from 1992 until 2019. PWUD with injecting drug use or opioid use disorder and chronic HCV infection were identified for inclusion in this study. HCV treatment initiation was the main outcome, and subdistribution proportional hazards modeling was used to assess the relationship with current OAT. RESULTS: In total, 13 803 PWUD with chronic HCV were included in this study. Among those currently on OAT at the end of the study period, 47% (2704/5770) had started HCV treatment, whereas 22% (1778/8033) of those not currently on OAT had started HCV treatment. Among PWUD with chronic HCV infection, current OAT was associated with higher likelihood of HCV treatment initiation in time to event analysis (adjusted hazard ratio 1.84 [95% confidence interval {CI}, 1.50, 2.26]). CONCLUSIONS: Current OAT was associated with a higher likelihood of HCV treatment initiation. However, many PWUD with HCV currently receiving OAT have yet to receive HCV treatment. Enhanced integration between substance use care and HCV treatment is needed to improve the overall health of PWUD.
Authors: Nazrul Islam; Mel Krajden; Jean Shoveller; Paul Gustafson; Mark Gilbert; Jane A Buxton; Jason Wong; Mark W Tyndall; Naveed Zafar Janjua Journal: Lancet Gastroenterol Hepatol Date: 2016-12-23
Authors: Louisa Degenhardt; Bradley M Mathers; Andrea L Wirtz; Daniel Wolfe; Adeeba Kamarulzaman; M Patrizia Carrieri; Steffanie A Strathdee; Kasia Malinowska-Sempruch; Michel Kazatchkine; Chris Beyrer Journal: Int J Drug Policy Date: 2013-09-04
Authors: Sahar Bajis; Jason Grebely; Behzad Hajarizadeh; Tanya Applegate; Alison D Marshall; Mary Ellen Harrod; Jude Byrne; Nicky Bath; Phillip Read; Michael Edwards; Carla Gorton; Jeremy Hayllar; Victoria Cock; Steven Peterson; Claire Thomson; Martin Weltman; Meryem Jefferies; William Wood; Paul Haber; Nadine Ezard; Marianne Martinello; Lisa Maher; Gregory J Dore Journal: J Viral Hepat Date: 2019-12-06 Impact factor: 3.728
Authors: Carmine Rossi; Zahid A Butt; Stanley Wong; Jane A Buxton; Nazrul Islam; Amanda Yu; Maryam Darvishian; Mark Gilbert; Jason Wong; Nuria Chapinal; Mawuena Binka; Maria Alvarez; Mark W Tyndall; Mel Krajden; Naveed Z Janjua Journal: J Hepatol Date: 2018-08-22 Impact factor: 25.083
Authors: Naveed Zafar Janjua; Margot Kuo; Mei Chong; Amanda Yu; Maria Alvarez; Darrel Cook; Rosemary Armour; Ciaran Aiken; Karen Li; Seyed Ali Mussavi Rizi; Ryan Woods; David Godfrey; Jason Wong; Mark Gilbert; Mark W Tyndall; Mel Krajden Journal: PLoS One Date: 2016-03-08 Impact factor: 3.240