Brian Conway1, Julie Bruneau2, Curtis Cooper3, Chris Steingart4, Chris Fraser5, Kris Stewart6, Lucie Deshaies7, Réjean Thomas8, Duncan Webster9, Gisela Macphail10, Jeff Powis11, Joseph Cox12, Jordan J Feld13, Mark E McGovern14, Janie B Trepanier14, Martine Drolet14. 1. Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada. 2. Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada. 3. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 4. Sanguen Health Centre, Waterloo, Ontario, Canada. 5. Cool Aid Community Health Centre, Victoria, British Columbia, Canada. 6. Saskatoon Infectious Disease Care Network, Saskatoon, Saskatchewan, Canada. 7. Clinique Médicale Lauberivière, Lévis, Québec, Canada. 8. Clinique Médicale l'Actuel, Montréal, Québec, Canada. 9. Dalhousie University, Saint John, New Brunswick, Canada. 10. Calgary Urban Project Society (CUPS), Calgary, Alberta, Canada. 11. Toronto Community Hep C Program, Toronto, Ontario, Canada. 12. McGill University Health Centre, Montréal, Québec, Canada. 13. Centre for Liver Disease, Toronto General Hospital, Toronto, Ontario, Canada. 14. Merck Canada Inc, Kirkland, Québec, Canada.
Abstract
Background: People who use drugs (PWUD) are among the highest risk category for becoming infected with the hepatitis C virus (HCV) in Canada. There is a need for more information on the demographics of HCV-infected PWUD/PWID who have recently injected drugs or who are actively injecting drugs. Methods: CAPICA was a multicentre, retrospective database/chart review conducted from October 2015 to February 2016 that was designed to characterize HCV-infected people who inject drugs (PWID) and are enrolled in clinical care in Canada. The aim was to identify factors of health care engagement essential in the design systems of HCV care and treatment in this population. The study enrolled 420 patients with a history of injection drug use within the last 12 months who had been diagnosed with chronic viremic HCV infection and had been participants in an outpatient clinical care setting in the past 12 months. Patients who were co-infected with HIV/HCV were excluded. Results: Harm reduction programs were in place at 92% (11/12) of the sites, and 75% (9) of these sites offered opioid agonist therapy (OAT), with 48% of the patients currently taking OAT. HCV genotype 1a was most prevalent (56%), followed by G3 (34%), and the most common fibrosis score was F1 (34%). The average reinfection rate was about 5%. Seventeen percent of the patients were undergoing HCV treatment or had recently failed therapy, while 83% were not being treated. Conclusions: In a multivariate analysis, the following factors were significantly associated with treatment: increasing age (OR 1.10), a fibrosis score of F4 (OR 4.91), moderate alcohol consumption (OR 3.70), and not using a needle exchange program (OR 6.95).
Background: People who use drugs (PWUD) are among the highest risk category for becoming infected with the hepatitis C virus (HCV) in Canada. There is a need for more information on the demographics of HCV-infected PWUD/PWID who have recently injected drugs or who are actively injecting drugs. Methods: CAPICA was a multicentre, retrospective database/chart review conducted from October 2015 to February 2016 that was designed to characterize HCV-infected people who inject drugs (PWID) and are enrolled in clinical care in Canada. The aim was to identify factors of health care engagement essential in the design systems of HCV care and treatment in this population. The study enrolled 420 patients with a history of injection drug use within the last 12 months who had been diagnosed with chronic viremic HCV infection and had been participants in an outpatient clinical care setting in the past 12 months. Patients who were co-infected with HIV/HCV were excluded. Results: Harm reduction programs were in place at 92% (11/12) of the sites, and 75% (9) of these sites offered opioid agonist therapy (OAT), with 48% of the patients currently taking OAT. HCV genotype 1a was most prevalent (56%), followed by G3 (34%), and the most common fibrosis score was F1 (34%). The average reinfection rate was about 5%. Seventeen percent of the patients were undergoing HCV treatment or had recently failed therapy, while 83% were not being treated. Conclusions: In a multivariate analysis, the following factors were significantly associated with treatment: increasing age (OR 1.10), a fibrosis score of F4 (OR 4.91), moderate alcohol consumption (OR 3.70), and not using a needle exchange program (OR 6.95).
Authors: Jason Grebely; Olav Dalgard; Brian Conway; Evan B Cunningham; Philip Bruggmann; Behzad Hajarizadeh; Janaki Amin; Julie Bruneau; Margaret Hellard; Alain H Litwin; Philippa Marks; Sophie Quiene; Sharmila Siriragavan; Tanya L Applegate; Tracy Swan; Jude Byrne; Melanie Lacalamita; Adrian Dunlop; Gail V Matthews; Jeff Powis; David Shaw; Maria Christine Thurnheer; Martin Weltman; Ian Kronborg; Curtis Cooper; Jordan J Feld; Chris Fraser; John F Dillon; Phillip Read; Ed Gane; Gregory J Dore Journal: Lancet Gastroenterol Hepatol Date: 2018-01-06
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