Changes in risk behaviours during and following treatment for hepatitis C virus infection among people who inject drugs: The ACTIVATE study |
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| Institution: | 1. Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway;2. Institute of Clinical Medicine, University of Oslo, Norway;3. The Kirby Institute, UNSW Sydney, Australia;4. Vancouver Infectious Diseases Center, Vancouver, Canada;5. Ludwig Maximilians-University Munich, Munich, Germany;6. Arud Centres for Addiction Medicine, Zurich, Switzerland;7. CHUM Research Center, Université de Montréal, Montreal, Canada;8. Stuivenberg ZNA, Antwerp, Belgium;9. School of Medicine and Public Health, University of Newcastle, Newcastle, Australia;10. The Liver Unit, Queen Mary University of London, London, United Kingdom;11. Burnet Institute, Melbourne, Australia;12. Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium;13. Department of Hepatology, UZ Leuven, Leuven, Belgium;14. Faculty of Medicine and Life Sciences, Limburg Clinical Research Program, Hasselt University, Hasselt, Belgium;15. Division of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland;p. Nepean Hospital, Sydney, Australia;q. Department of Gastroenterology, Oslo University Hospital, Oslo, Norway;r. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia;1. School of Arts and Humanities, Edith Cowan University,270 Joondalup Drive, Joondalup WA 6027, Australia;2. Department of Psychological Science, Northern Kentucky University,1 Nunn Drive, MEP 355, Highland Heights, KY 41099, United States;1. School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland;2. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada;3. Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada;1. Department of Veterans Affairs Center for Limb Loss Prevention and Prosthetic Engineering,1660 S. Columbian Way, Seattle, WA 98108, United States;2. Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, United States;1. Gazi University, School of Medicine, Department of Internal Medicine, Section of Rheumatology, Ankara, Turkey;2. Rush Medical College, Department of Internal Medicine, Section of Rheumatology, Department of Biochemistry, Chicago, IL, USA;1. Roessingh Research and Development P.O. Box 310, 7500 AH Enschede, The Netherlands;2. University of Twente MIRA research institute for Biomedical Technology and Technical Medicine Department of Biomechanical Engineering P. O. Box 217, 7500 AE Enschede, The Netherlands;3. Roessingh, Center for Rehabilitation P.O. Box 310 7500 AE Enschede, The Netherlands;4. Military Rehabilitation Centre ‘Aardenburg’ Department Research and Development P.O. Box 185, 3940 AD Doorn, The Netherlands |
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| Abstract: | BackgroundThe 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).MethodsACTIVATE 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.ResultsAmong 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).ConclusionsRecent 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. |
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| Keywords: | Hepatitis C virus People who inject drugs Antiviral treatment Injecting drug use Risk behaviours Opioid substitution treatment Alcohol use |
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