Theme: Epidemiology & Public Health Research Year: 2024
Background: In 2016, the World Health Organization (WHO) called for the elimination of viral hepatitis. Prevalence of Hepatitis C virus (HCV) infection among people who use drugs has been confirmed worldwide to exceed that observed in general population. Opioid substitution treatment services targeting drug-dependent patients provide convenient points of contact for the implementation of service initiatives for screening and elimination of HCV infection. In Poland universal screening involving drug users has not been introduced so far.
Methods: In 2021 Polish Group of HCV Experts in collaboration with National Consultant in Psychiatry and Polish Psychiatric Association had started the project of national multicenter HCV screening in psychiatric hospitals and clinics.
Results: Among 12 902 patients tested in 24 centers 117 methadone maintenance patients were identified, among whom 29 (24.7%) anti-HCV positive were found and 22 (18.8%) of them were HCV-RNA positive. Median age of anti-HCV positive was 46 years and 66% were male. Previous HCV treatment history was recorded in 16% od anti-HCV positive patients and more than 95% had been already tested for HCV. Increased ALT level was diagnosed in 37% of patients.
Homelessness was declared by 4.3%.
The main risk factors identified in anti-HCV population were: Use(d) anytime drugs other than injected – 93%; Tattooing – 64%; Stay in a penitentiary (also as suspected) – 50%; Self-harm – 47%; Cosmetic/ beauty treatments in the past – 47%; Injecting drugs whenever – 91%; Blood transfusion before 1992 – 4%; Dialysis – 1%.
Conclusion: Methadone maintenance patients exhibit a number of risk factors, including intravenous drug use, self-harm and incarceration, that make HCV infection more possible. They are also older, have a higher prevalence of psychiatric illness and treatment is usually more problematic. To recognize prevalence, risk of reinfection (need for HCV-RNA testing) and implementation of appropriate cascade of care are of extremal importance.
Disclosure of Interest Statement:
The study was supported by Gilead Sciences