Opioid agonist therapy increases linkage to HCV care among PWID
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Opioid agonist therapy can increase linkage to hepatitis C virus care among people who inject drugs, or PWID, according to a systematic review in Clinical Infectious Diseases.
“Opioid agonist therapy reduces harms across multiple health outcomes for people who are opioid dependent. This includes reductions in injecting risk behaviour, risk for HIV and hepatitis C virus (HCV) infections, criminal activity, all-cause mortality and overdose mortality,” Jason Grebely, PhD, BSc, professor and senior research fellow in the viral hepatitis clinical research program at the Kirby Institute in Australia and president of the International Network on Hepatitis in Substance Users, told Healio. “Opioid agonist therapy has also been shown to improve engagement in HIV treatment, adherence and virologic suppression.”
Grebely added: “However, to our knowledge, no study has evaluated whether opioid agonist therapy is associated with HCV testing, treatment uptake and treatment outcomes among PWID.”
The researchers reviewed bibliographic databases and conference presentations for studies that examined the relationship between opioid agonist therapy and HCV testing, treatment and treatment outcomes among PWID. The final analysis included 22 studies conducted in Australia, Europe, North America and Thailand.
Opioid agonist treatment both recent and at any time was associated with improved HCV testing and treatment uptake among PWID, according to Grebely. Study data showed that current or recent opioid agonist treatment correlated with an increased odds of recent HCV antibody testing (4 studies; OR = 1.80; 95% CI, 1.36-2.39), HCV RNA testing among those who were HCV antibody positive (2 studies; OR = 1.83; 95% CI, 1.27-2.62) and uptake of direct-acting antiviral treatment among those who were HCV RNA positive (7 studies; OR = 1.53; 95% CI, 1.07-2.20). Grebely added that recent opioid agonist therapy was not associated with DAA treatment completion or response to therapy.
The findings provide data that support the integration of HCV services in settings where treatment with opioid agonist therapy is provided, according to Grebely. He also noted that the co-location of services for addressing HCV and opioid dependence among people who use drugs allows for integrated care to improve HCV testing and treatment uptake.
“Further work is needed to understand strategies to optimize HCV testing and treatment within drug treatment settings and improve the overall health of people who use drugs,” Grebely said. “Given the considerable burden of HCV among PWID, strategies to enhance care in this population will be critical for achieving global hepatitis elimination goals.”
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