Grebely, Jason, Alavi, Maryam, Micallef, Michelle, Dunlop, Adrian J., Balcomb, Anne C., Phung, Nghi, Weltman, Martin D., Day, Carolyn A., Treloar, Carla, Bath, Nicky, Haber, Paul S., Dore, Gregory J., and ETHOS Study Group, (2016) Treatment for hepatitis C virus infection among people who inject drugs attending opioid substitution treatment and community health clinics: the ETHOS Study. Addiction, 111 (2). pp. 311-319.

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Abstract

AimsTo estimate adherence and response to therapy for chronic hepatitis C virus (HCV) infection among people with a history of injecting drug use. A secondary aim was to identify predictors of HCV treatment response. DesignProspective cohort recruited between 2009 and 2012. Participants were treated with peg-interferon alfa-2a/ribavirin for 24 (genotypes 2/3, G2/3) or 48weeks (genotype 1, G1). SettingSix opioid substitution treatment (OST) clinics, two community health centres and one Aboriginal community-controlled health organization providing drug treatment services in New South Wales, Australia. ParticipantsAmong 415 people with a history of injecting drug use and chronic HCV assessed by a nurse, 101 were assessed for treatment outcomes (21% female). MeasurementsStudy outcomes were treatment adherence and sustained virological response (SVR, undetectable HCV RNA 24weeks post-treatment). FindingsAmong 101 treated, 37% (n=37) had recently injected drugs (past 6months) and 62% (n=63) were receiving OST. Adherence 80% was 86% (n=87). SVR was 74% (75 of 101), with no difference observed by sex (males: 76%, females: 67%, P=0.662). In adjusted analysis, age <35 (versus 45years) adjusted odds ratio (aOR)=5.06, 95% confidence interval (CI)=1.47, 17.40] and on-treatment adherence 80% independently predicted SVR (aOR=19.41, 95% CI=3.61, 104.26]. Recent injecting drug use at baseline was not associated with SVR. ConclusionsPeople with a history of injecting drug use and chronic hepatitis C virus attending opioid substitution treatment and community health clinics can achieve adherence and responses to interferon-based therapy similar to other populations, despite injecting drugs at baseline. Younger age and adherence are predictive of improved response to hepatitis C virus therapy.

Item ID:	81292
Item Type:	Article (Research - C1)
ISSN:	1360-0443
Keywords:	Antiviral therapy; hepatitis C virus; injecting drug use; methadone; opioid substitution treatment; people who inject drugs
Copyright Information:	© 2015 Society for the Study of Addiction.
Date Deposited:	05 Dec 2023 23:39
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50% 42 HEALTH SCIENCES > 4203 Health services and systems > 420305 Health and community services @ 50%
SEO Codes:	20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes @ 100%
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