Theme: Clinical Research Year: 2019
Background: People who inject drugs (PWID) are underrepresented among those who receive
hepatitis C virus (HCV) treatment, compared to people without injection drug use (IDU); yet, most
new HCV infections are among PWID. It is hypothesized that Opioid Agonist Therapy (OAT) may
improve uptake of HCV treatment among PWID. Characterising HCV treatment uptake among PWID
and those on OAT may inform public health policy/programming.
Methods: BC (British Columbia) Hepatitis Testers Cohort was used, which includes all
individuals tested for or diagnosed with HCV in BC since January 1st 1996, linked to all
prescription drugs, medical visits, hospitalizations and mortality data until June 30th 2018.
People diagnosed with chronic HCV identified as PWID (using previously validated algorithm),
or ever received OAT, were selected. OAT was classified as; never, recent (<6 months before
HCV treatment initiation, or June 30th 2018 if untreated), or past (>6 months before HCV
treatment initiation, or June 30th 2018 if untreated). Differences in HCV treatment uptake
according to OAT history were assessed using χ
2
test.
Results: Overall, 31% (2,928 /9,521) never on OAT, 29% (2,464 /8,636) with recent OAT, and 14%
(986/7,261, p=<0.0001) with past OAT received HCV treatment. Proportions receiving HCV
treatment, stratified by IDU and OAT history were: past OAT; 13% (308/2421) recent PWID, 14%
(438/3113) past PWID, 14% (240/1727) never PWID, recent OAT; 24% (1002/4110) recent PWID,
34% (943/2744) past PWID, 35% (670/1933) never PWID, never OAT; 31% (960/3128) recent PWID,
29% (1817/6242) past PWID.
Conclusion: OAT coverage among many indicated to receive it remains sub-optimal. However,
progression to HCV treatment was similar between those never on OAT, compared to those recently
receiving OAT. Those with past OAT had lowest HCV treatment uptake. PWID and those on OAT
must be involved in designing public health strategies supporting re-engagement/engagement with
OAT and HCV treatment uptake.
Disclosure of Interest Statement: All inferences, opinions, and conclusions drawn are those of the
authors, and do not necessarily reflect the opinions or policies of the authors’ affiliated
organisations. SRB is supported by a CIHR and Michael Smith Foundation for Health Research Health
System Impact Postdoctoral Fellowship Award. MP is supported by a CIHR Health System Impact
Postdoctoral Fellowship Award. MK has received grant funding via his institution from Roche
Molecular Systems, Boehringer Ingelheim, Merck, Siemens Healthcare Diagnostics and Hologic Inc