Theme: Epidemiology & Public Health Research Year: 2025
Background:
Hepatitis C virus (HCV) and skin and soft tissue infections (SSTIs) are prevalent among people who inject drugs (PWID). Barriers to care for SSTIs overlap with those for HCV. Engagement in HCV care may have positive spillover effects, presenting an opportunity for harm reduction, but such effects have yet to be demonstrated. We aimed to estimate the effects of HCV treatment initiation on the SSTI healthcare burden.
Methods:
We used Quebec’s Public Health Mandatory Reportable Infectious Disease database, which links reported HCV cases with lab and administrative health data. A validated algorithm was used to identify PWID living with HCV. Using inverse probability treatment weighting and balanced interrupted time series with control, we compared SSTI diagnoses and hospitalizations among PWID who initiated HCV treatment, between 2014 and 2018 inclusive, to those who did not.
Results:
Among 3787 eligible PWID who were HCV positive, 996 had a record of initiating treatment. In the three-year pre-period, there were 750 diagnoses and 105 hospitalizations among untreated individuals, and 870 diagnoses and 129 hospitalizations among those treated; while in the postperiod, there were 565 diagnoses and 89 hospitalizations among those untreated and 338 diagnoses and 50 hospitalizations among those treated. We observed (Figure 1) a significant level change (- 0.18, 95%CI: -0.349, -0.012) in SSTI diagnoses after treatment and a steady annual trend (-0.11, 95%CI: -0.24, 0.01) per 100,000 individuals. While there was no immediate level effect on STTI hospitalizations (-0.016, 95%CI: -0.083, 0.049), there was a significant annual decline in additional hospitalizations (-0.06, 95%CI: – 0.10, -0.01) per 100,000 individuals
Conclusion:
HCV treatment initiation may have an immediate, although modest, effect on reducing SSTI infections and a more prolonged effect on severe infections requiring hospitalization. This suggests that HCV treatment could provide an opportunity to address other burdensome health issues.
Disclosure of Interest Statement:
El Sheikh MZ and Panagiotoglou D have no conflicts to disclose. Greenaway C received grants for investigator-initiated studies from Gilead and consulting fees from AbbVie. Klein MB received grants for investigator-initiated studies from ViiV Healthcare, AbbVie, Merck, and Gilead and consulting fees from ViiV Healthcare, Merck, AbbVie, and Gilea, and participated on a Data Safety Monitoring Board or Advisory Board for AbbVie, Gilead and ViiV Healthcare. No pharmaceutical grants were received in the development of this study.
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