Patterns of Drug and Alcohol Use and Injection Equipment Sharing Among People With Recent Injecting Drug Use or Receiving Opioid Agonist Treatment During and Following Hepatitis C Virus Treatment With Direct-acting Antiviral Therapies: An International Study.

Analgesics, Opioid / therapeutic use Antiviral Agents / therapeutic use Drug Therapy, Combination Female Hepacivirus Hepatitis C / drug therapy Hepatitis C, Chronic / drug therapy Humans Male Middle Aged Pharmaceutical Preparations Ribavirin / therapeutic use Substance Abuse, Intravenous / complications Sustained Virologic Response
DAA PWID drug use hepatitis C injecting drug use

Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
23 05 2020
Historique:
received: 19 03 2019
accepted: 10 07 2019
pubmed: 14 7 2019
medline: 7 1 2021
entrez: 14 7 2019
Statut: ppublish

Résumé

In many settings, recent or prior injection drug use remains a barrier to accessing direct-acting antiviral treatment (DAA) for hepatitis C virus (HCV) infection. We examined patterns of drug and alcohol use and injection equipment sharing among people with recent injecting drug use or receiving opioid agonist treatment (OAT) during and following DAA-based treatment. SIMPLIFY and D3FEAT are phase 4 trials evaluating the efficacy of DAA among people with past 6-month injecting drug use or receiving OAT through a network of 25 international sites. Enrolled in 2016-2017, participants received sofosbuvir/velpatasvir (SIMPLIFY) or paritaprevir/ritonavir/dasabuvir/ombitasvir ± ribavirin (D3FEAT) for 12 weeks and completed behavioral questionnaires before, during, and up to 2 years posttreatment. The impact of time in HCV treatment and follow-up on longitudinally measured longitudinally measured behaviors was estimated using generalized estimating equations. At screening, of 190 participants (mean age, 47 years; 74% male), 62% reported any past-month injecting 16% past-month injection equipment sharing, and 61% current OAT. Median alcohol use was 2 (Alcohol Use Disorders Identification Test-Consumption; range, 1-12). During follow-up, opioid injecting (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.92-0.99) and sharing (OR, 0.87; 95% CI, 0.80-0.94) decreased, whereas no significant changes were observed for stimulant injecting (OR, 0.98; 95% CI, 0.94-1.02) or alcohol use (OR, 0.99; 95% CI, 0.95-1.04). Injecting drug use and risk behaviors remained stable or decreased following DAA-based HCV treatment. Findings further support expanding HCV treatment to all, irrespective of injection drug use. SIMPLIFY, NCT02336139; D3FEAT, NCT02498015.

Sections du résumé

BACKGROUND
In many settings, recent or prior injection drug use remains a barrier to accessing direct-acting antiviral treatment (DAA) for hepatitis C virus (HCV) infection. We examined patterns of drug and alcohol use and injection equipment sharing among people with recent injecting drug use or receiving opioid agonist treatment (OAT) during and following DAA-based treatment.
METHODS
SIMPLIFY and D3FEAT are phase 4 trials evaluating the efficacy of DAA among people with past 6-month injecting drug use or receiving OAT through a network of 25 international sites. Enrolled in 2016-2017, participants received sofosbuvir/velpatasvir (SIMPLIFY) or paritaprevir/ritonavir/dasabuvir/ombitasvir ± ribavirin (D3FEAT) for 12 weeks and completed behavioral questionnaires before, during, and up to 2 years posttreatment. The impact of time in HCV treatment and follow-up on longitudinally measured longitudinally measured behaviors was estimated using generalized estimating equations.
RESULTS
At screening, of 190 participants (mean age, 47 years; 74% male), 62% reported any past-month injecting 16% past-month injection equipment sharing, and 61% current OAT. Median alcohol use was 2 (Alcohol Use Disorders Identification Test-Consumption; range, 1-12). During follow-up, opioid injecting (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.92-0.99) and sharing (OR, 0.87; 95% CI, 0.80-0.94) decreased, whereas no significant changes were observed for stimulant injecting (OR, 0.98; 95% CI, 0.94-1.02) or alcohol use (OR, 0.99; 95% CI, 0.95-1.04).
CONCLUSIONS
Injecting drug use and risk behaviors remained stable or decreased following DAA-based HCV treatment. Findings further support expanding HCV treatment to all, irrespective of injection drug use.
CLINICAL TRIALS REGISTRATION
SIMPLIFY, NCT02336139; D3FEAT, NCT02498015.

Identifiants

DOI: 10.1093/cid/ciz633 PMID: 31300820 PMC: PMC7245153
pubmed: 31300820
pii: 5531892
doi: 10.1093/cid/ciz633
pmc: PMC7245153
doi:

Substances chimiques

Analgesics, Opioid 0
Antiviral Agents 0
Pharmaceutical Preparations 0
Ribavirin 49717AWG6K

Banques de données

ClinicalTrials.gov
['NCT02336139', 'NCT02498015']

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

2369-2376

Subventions

Organisme : NIDA NIH HHS
ID : R01 DA040506
Pays : United States

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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Auteurs

Andreea A Artenie (AA)

Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Canada.
Research Centre, Centre Hospitalier de l'Université de Montréal, Canada.

Evan B Cunningham (EB)

Kirby Institute, University of New South Wales, Australia.

Gregory J Dore (GJ)

Kirby Institute, University of New South Wales, Australia.
Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia.

Brian Conway (B)

Vancouver Infectious Diseases Centre, Canada.

Olav Dalgard (O)

Department of Infectious Disease, Akershus University Hospital, Oslo, Norway.

Jeff Powis (J)

South Riverdale Community Health Centre, Toronto, Canada.

Philip Bruggmann (P)

Arud Centres for Addiction Medicine, Zurich, Switzerland.

Margaret Hellard (M)

Centre for Population Health, Burnet Institute, Australia.
Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.

Curtis Cooper (C)

Ottawa Hospital Research Institute, Canada.

Philip Read (P)

Kirby Institute, University of New South Wales, Australia.
Kirketon Road Centre, Sydney, Australia.

Jordan J Feld (JJ)

Toronto General Hospital Research Institute, Canada.

Behzad Hajarizadeh (B)

Kirby Institute, University of New South Wales, Australia.

Janaki Amin (J)

Kirby Institute, University of New South Wales, Australia.
Department of Health Systems and Populations, Macquarie University, Sydney, Australia.

Karine Lacombe (K)

Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, Paris, France.
Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France.

Catherine Stedman (C)

Department of Medicine, University of Otago, New Zealand.

Alain H Litwin (AH)

Department of Medicine, School of Medicine Greenville, University of South Carolina.
Department of Medicine, School of Health Research, Clemson University, Greenville, South Carolina.
Prisma Health-Upstate, Greenville, South Carolina.

Pip Marks (P)

Kirby Institute, University of New South Wales, Australia.

Gail V Matthews (GV)

Kirby Institute, University of New South Wales, Australia.
Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia.

Sophie Quiene (S)

Kirby Institute, University of New South Wales, Australia.

Amanda Erratt (A)

Kirby Institute, University of New South Wales, Australia.

Julie Bruneau (J)

Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Canada.
Research Centre, Centre Hospitalier de l'Université de Montréal, Canada.

Jason Grebely (J)

Kirby Institute, University of New South Wales, Australia.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Stupéfiants › Analgésiques morphiniques › Patterns of Drug and Alcohol Use and Injection...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antiviraux › Patterns of Drug and Alcohol Use and Injection...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Association de médicaments › Patterns of Drug and Alcohol Use and Injection...
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questionsmedicales.fr › Acides nucléiques, nucléotides et nucléosides › Nucléosides › Ribonucléosides › Ribavirine › Patterns of Drug and Alcohol Use and Injection...
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questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Réponse virologique soutenue › Patterns of Drug and Alcohol Use and Injection...