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Title: | Changes in risk behaviours during and following treatment for hepatitis C virus infection among people who inject drugs: The ACTIVATE study | Authors: | Midgard, Havard Hajarizadeh, Behzad Cunningham, Evan B. Conway, Brian Backmund, Markus Bruggmann, Philip Bruneau, Julie Bourgeois, Stefan Dunlop, Adrian Foster, Graham R. Hellard, Margaret ROBAEYS, Geert Thurnheer, Maria C. Weltman, Martin Amin, Janaki Marks, Philippa S. Quiene, Sophie Dore, Gregory J. Dalgard, Olav Grebely, Jason |
Issue Date: | 2017 | Publisher: | ELSEVIER SCIENCE BV | Source: | INTERNATIONAL JOURNAL OF DRUG POLICY, 47, p. 230-238 | Abstract: | Background: The risk of hepatitis C virus (HCV) reinfection due to continued injecting risk behaviours might remain a barrier to HCV treatment among people who inject drugs. We aimed to evaluate changes in risk behaviours during and following HCV treatment among people with ongoing injecting drug use or receiving opioid substitution treatment (OST). Methods: ACTIVATE was an international multicentre clinical trial conducted between 2012 and 2014. Participants with HCV genotypes 2/3 infection were treated with peg-interferon/ribavirin for 12 or 24 weeks and completed a self-administered behavioural questionnaire at each study visit. The impact of time in treatment and follow-up on longitudinally measured recent (past month) behavioural outcomes was evaluated using generalized estimating equations. Results: Among 93 enrolled participants (83% male, median age 41 years), 55 (59%) had injected in the past month. Any injecting drug use decreased during HCV treatment and follow-up (OR 0.89 per incremental study visit; 95% CI 0.83-0.95). No significant changes were found in >= daily injecting (OR 0.98; 95% CI 0.89-1.07), use of non-sterile needles (OR 0.94; 95% CI 0.79-1.12), sharing of injecting paraphernalia (OR 0.87; 95% CI 0.70-1.07) or non-injecting drug use (OR 1.01; 95% CI 0.92-1.10). Hazardous alcohol use decreased throughout (OR 0.56; 95% CI 0.40-0.77) and OST increased between enrolment and end of treatment (OR 1.48; 95% CI 1.07-2.04). Conclusions: Recent injecting drug use and hazardous alcohol use decreased, while OST increased during and following HCV treatment among participants with ongoing injecting drug use. These findings support further expansion of HCV care among PWID. (C) 2017 Elsevier B.V. All rights reserved. | Notes: | [Midgard, Havard; Dalgard, Olav] Akershus Univ Hosp, Dept Infect Dis, Lorenskog, Norway. [Midgard, Havard; Dalgard, Olav] Univ Oslo, Inst Clin Med, Oslo, Norway. [Midgard, Havard; Hajarizadeh, Behzad; Cunningham, Evan B.; Amin, Janaki; Marks, Philippa S.; Quiene, Sophie; Dore, Gregory J.; Grebely, Jason] UNSW Sydney, Kirby Inst, Sydney, NSW, Australia. [Conway, Brian] Vancouver Infect Dis Ctr, Vancouver, BC, Canada. [Backmund, Markus] Ludwig Maximilians Univ Munchen, Munich, Germany. [Bruggmann, Philip] Arud Ctr Addict Med, Zurich, Switzerland. [Bruneau, Julie] Univ Montreal, CHUM Res Ctr, Montreal, PQ, Canada. [Bourgeois, Stefan] Stuivenberg ZNA, Antwerp, Belgium. [Dunlop, Adrian] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia. [Foster, Graham R.] Queen Mary Univ London, Liver Unit, London, England. [Hellard, Margaret] Burnet Inst, Melbourne, Vic, Australia. [Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium. [Robaeys, Geert] UZ Leuven, Dept Hepatol, Leuven, Belgium. [Robaeys, Geert] Hasselt Univ, Limburg Clin Res Program, Fac Med & Life Sci, Hasselt, Belgium. [Thurnheer, Maria C.] Univ Hosp, Div Infect Dis, Bern, Switzerland. [Thurnheer, Maria C.] Univ Bern, Bern, Switzerland. [Weltman, Martin] Nepean Hosp, Sydney, NSW, Australia. [Midgard, Havard] Oslo Univ Hosp, Dept Gastroenterol, Oslo, Norway. [Amin, Janaki] Macquarie Univ, Fac Med & Hlth Sci, Sydney, NSW, Australia. | Keywords: | Hepatitis C virus; People who inject drugs; Antiviral treatment; Injecting drug use; Risk behaviours; Opioid substitution treatment; Alcohol use;Hepatitis C virus; People who inject drugs; Antiviral treatment; Injecting drug use; Risk behaviours; Opioid substitution treatment; Alcohol use | Document URI: | http://hdl.handle.net/1942/26267 | ISSN: | 0955-3959 | e-ISSN: | 1873-4758 | DOI: | 10.1016/j.drugpo.2017.05.040 | ISI #: | 000412613000029 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
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