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

Andreea A. Artenie*, Evan B. Cunningham, Gregory J. Dore, Brian Conway, Olav Dalgard, Jeff Powis, Philip Bruggmann, Margaret Hellard, Curtis Cooper, Philip Read, Jordan J. Feld, Behzad Hajarizadeh, Janaki Amin, Karine Lacombe, Catherine Stedman, Alain H. Litwin, Pip Marks, Gail V. Matthews, Sophie Quiene, Amanda Erratt & 2 others Julie Bruneau, Jason Grebely

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2369-2376
Number of pages8
JournalClinical Infectious Diseases
Volume70
Issue number11
DOIs
Publication statusPublished - 23 May 2020

Keywords

  • DAA
  • drug use
  • hepatitis C
  • injecting drug use
  • PWID

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