The Relationship Between Opioid Agonist Therapy and Hepatitis C Virus Seroprevalence Among People who Inject Drugs in Southern Appalachian Ohio in 2019

Author: Daniel Brook Christine Schalkoff Hannah Piscalko Adams Sibley Angela Estadt David Kline Kathryn Lancaster Vivian Go William Miller William

Theme: Epidemiology & Public Health Research Year: 2022

The United States is experiencing a hepatitis C virus (HCV) epidemic among people who inject drugs
(PWID), especially in rural Appalachia. Opioid agonist therapy (OAT), including maintenance therapy
with buprenorphine (BMT) or methadone (MMT), may prevent HCV infection by reducing injection drug
use. Syringe service programs (SSP) in conjunction with OAT may enhance HCV prevention. We assessed
the relationship between OAT use and HCV antibody seroprevalence among rural PWID.
We conducted a cross-sectional respondent-driven sampling survey of 186 PWID in Appalachian Ohio
from March to October 2019. HCV prevalence was determined with the OraQuick rapid antibody
test. We defined current OAT as self-reported OAT in the past 30 days; we defined prior OAT as selfreported OAT any time before the past 30 days. We fit three adjusted modified negative binomial
regression models to assess the relationship between HCV antibody seroprevalence and 1) recency of
BMT use; 2) recency of MMT use; and 3) any BMT versus any MMT use. We examined effect measure
modification between OAT and HCV seroprevalence by participants’ use of an SSP.
Eighty-two percent of participants were HCV antibody positive (n=153). Nearly 2/3 (64%; n=119) of
participants had a history of BMT, while only 19% (n=36) had a history of MMT. Among participants who
did not primarily use an SSP, those currently using BMT had a higher adjusted prevalence of HCV
antibody positivity than those with no BMT history (adjusted prevalence ratio=1.5 [95% confidence
interval=1.1, 2.0]; Figure 1). We found no differences in the prevalence of HCV antibody seroprevalence
by type of OAT or by the recency of MMT.
Rural PWID who are not retained in OAT and do not use SSPs may represent a particularly high-risk
group for HCV. PWID in OAT should be counseled on accessing SSPs.
Disclosure of Interest Statement:
All authors have no conflicts of interest to disclose.

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