Most opioid users alter substance-use behavior after positive HCV tests

WASHINGTON — Most opioid users who screened positive for hepatitis C altered their substance-use behavior within 1 year, according to a presentation at The Liver Meeting 2017.

“Evidence shows that reduced injection drug use has important health benefits, most on the individual level in terms of reducing the direct health consequences for the individual but also on a societal level in terms of decreasing the rate of HCV and infection transmission,” Hooman Farhang Zangneh, from the Toronto Centre for Liver Disease, Toronto General Hospital, University of Toronto, said in his presentation.

According to Zangneh, the use of opioids and synthetic opioids and the rates of overdose related to opioid use has increased significantly in North America in the last 15 years, especially among those aged between 20 years and 40 years. The prevalence of HCV in Canada is between 0.3% and 0.9% and occurs more commonly among opioid-dependent individuals. In the province of Ontario, there are more than 50,000 opioid-dependent individuals engaged in opioid substitution therapy.

To determine the effect of HCV screening on substance use among this population, the researchers identified 2,406 individuals from 43 addiction clinics from 2003 to 2014 and collected electronic health data, urine toxicology and antibody-based HCV screening data.

Of the 527 individuals who previously tested positive for anti-HCV antibody, 328 were men, mean age was 41 years and 88% were from urban areas. Substance use was evaluated 1 year prior to and 1 year after HCV screening.

More than half of the individuals who tested positive for HCV were significantly more likely to alter their substance-use behaviors and reduce consumption of non-prescribed opioids based on urine toxicology (53.1%) compared with those who screen negative, after adjustment for age, sex and geographic location (adjusted OR = 0.653; 95% CI, 0.803-0.531).

Additionally, those who received an HCV diagnosis had a significantly lower proportion of urine drug screens positive for non-prescribed opioids (aOR = 0.743), benzodiazepines (aOR = 0.631) and cocaine (aOR = 0.625) 1 year after screening.

“This highlights the importance of testing for HCV in this population as treatment for HCV had preferable health outcomes,” Zangneh concluded. “We need to evaluate those patients who have never been tested for HCV antibody to see if the duration of time from treatment would lead to the same result as we have right now.” – by Talitha Bennett

Reference:

Zangneh HF, et al. Abstract 125. Presented at: The Liver Meeting; Oct. 20-24, 2017; Washington, D.C.

Disclosure: Zangneh reports no relevant financial disclosures.