Evaluation of the Impact of HIV Diagnosis on the Hepatitis C Virus Care Cascade and Risk Behaviours Among Persons Receiving Medication Treatment for Opioid Use Disorder

Author: Audun Lier Brent Vander Wyk Sandra Springer

Theme: Clinical Research Year: 2022

Persons who inject drugs (PWID) are at increased risk for acquiring Hepatitis C Virus (HCV).
Medications for opioid use disorder (MOUD) are associated with reduced injection drug use (IDU)
and sex risk behavior (SRB) among persons with opioid use disorder (OUD). However, whether HCV
treatment uptake or changes in risk behavior differ by HIV serostatus among persons receiving
MOUD is incompletely understood.

A secondary analysis was performed from two prospective cohort studies of persons living with
(PLH) and without HIV with DSM-5 diagnosed OUD who were initiated on methadone,
buprenorphine, or naltrexone. Self-reported intravenous (IV) heroin use, stimulant use, SRB, HIV and
HCV status and uptake and completion of HCV treatment was obtained at baseline and 90 days after
initiation of MOUD. Data was compared by HIV status.

Of 129 participants, 78 (60.5%) were HCV antibody positive. PLH had increased HCV viral load testing
(80.0% vs. 42.1%, p = 0.0006) and initiation on direct acting antiviral treatment (66.67% vs. 20.0%, p
= 0.022), but had lower baseline mean proportion of reported IV opioid use (21.0 vs 11.2 days out of
30, p <0.001) and a lesser reduction in IV opioid use at 90 days (2.0 vs 10.7 fewer days out of 30, p
<0.001). SRB or stimulant use did not differ between groups.

PLH who received MOUD had improved HCV diagnosis and treatment uptake. MOUD reduced opioid
IDU more profoundly among those without HIV. Improved integration of concomitant OUD with HCV
and HIV treatment is needed.

Disclosure of Interest Statement:

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