OST tied to higher odds of HCV testing among Danish drug users

  • Øvrehus A & al.
  • Addiction
  • 22 Oct 2018

  • curated by Yael Waknine
  • Univadis Clinical Summaries
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Takeaway

  • Receipt of opioid substitution therapy (OST) is the greatest predictor of HCV screening among Danish individuals in treatment from drug use.

Why this matters

  • The lag observed between IDU initiation and first HCV test suggests a need for upscaled screening outside OST settings.

Study design

  • Registry-based study of 5483 individuals (median age, 23 years; 25% female) treated for drug use during 1996-2015.
  • 50% reported IDU or OST; 32% of IDU reported injecting stimulants.
  • Funding: Gilead Nordic Fellowship, University and Region of Southern Denmark.    

Key results

  • HCV test uptake was 51.9% overall, and higher among high-risk vs low-risk individuals (76.6% vs 31.1; P<.01>
  • Median time from first IDU to HCV testing, 6.5 years.
  • At end of follow-up, 21.2% of remaining individuals were HCV RNA+.
  • In multivariate analysis, predictors of HCV testing included:
    • Receiving OST (OR=3.7).
    • Ever IDU (OR=2.3)
    • Female gender (OR=1.7)
    • Connection to hepatitis outreach centers (OR=1.4; P<.01 for all>
  • Predictors of HCV included IDU (OR=6.7; P<.01 and history of ost p>
  • 69% of 531 HCV+ individuals were in drug use treatment at end of follow-up.
  • After 2010, only 4.7% of new participants reported opiates as the drug of choice and 17% reported IDU.

Limitations

  • Retrospective, observational design.

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