Opioid therapy may be a critical opportunity to engage people who inject drugs (PWID) in treatment for Hepatitis C virus, a study from researchers at the University at Albany School of Public Health suggests.
The study, published in the International Journal of Drug Policy, analyzed data from interviews with 1,613 PWID in Ukraine, where more than 70 percent of PWID are estimated to be infected with Hepatitis C virus (HCV). Getting tested for antibodies to HCV and confirming chronic HCV infection are necessary steps in the HCV treatment cascade. However, among the 1,002 individuals who were HCV positive (62.1 percent of the sample), only 56.7 percent were aware of their HCV-positive status and just over a third (34.5 percent) had received confirmatory testing. Engagement in opioid agonist therapy (i.e., receipt of methadone or buprenorphine) was a strong predictor of both awareness of one’s HCV-positive status and receipt of confirmatory testing for chronic HCV infection. These findings are consistent with previous work showing the benefits of opioid therapy for HIV and tuberculosis treatment cascades. Other correlates of HCV-status awareness and confirmatory testing in this study included indicators of social support, higher income, and receipt of antiretroviral therapy for HIV. Currently in Ukraine, only a small proportion of the estimated 340,000 opioid injectors have access to opioid access therapy and HCV treatment coverage is also quite low. Continuing efforts to expand opioid therapy will help to control the epidemic of opioid use while having the adding benefit of improving awareness of HCV status and ultimately receipt of HCV treatment.
The study was completed by Ms. Olena Iakunchykova as her master’s thesis in epidemiology, under the direction of Dr. Melissa Tracy, assistant professor of epidemiology. Co-authors from ICF Alliance for Public Health in Ukraine, Johns Hopkins Bloomberg School of Public Health, and Yale University Schools of Medicine and Public Health also contributed to this research.