Impact of Hepatitis C treatment on behavioural change in relation to drug use in people who inject drugs: A systematic review

Abstract

Impact of Hepatitis C treatment on behavioural change in relation to drug use in people who inject drugs: a systematic review

Health care utilization and costs associated with direct-acting antivirals for patients with substance use disorders and chronic hepatitis C

“…67,68 In light of this information, our finding that SUD-related ED visits and long-term care visits had a significantly greater reduction in the rate for the DAA group than for the non-DAA group among patients with SUD and chronic HCV without cirrhosis may suggest that the benefits of DAAs extend beyond liver-related outcomes, with treatment having a positive effect on patients' highrisk behaviors, especially among those without cirrhosis. 69 On the one hand, our finding of notable decreasing trends in SUD-related visits counters the argument that treating patients with SUD and chronic HCV with DAAs could lead to increased injection drug use or risky behaviors. 31,69,70 On the other hand, it is also likely that the reduction in SUD-related visits reflects that patients in the DAA group are ready to make health changes and are more willing to accept harm reduction education (eg, sterile syringe access).…”

“…69 On the one hand, our finding of notable decreasing trends in SUD-related visits counters the argument that treating patients with SUD and chronic HCV with DAAs could lead to increased injection drug use or risky behaviors. 31,69,70 On the other hand, it is also likely that the reduction in SUD-related visits reflects that patients in the DAA group are ready to make health changes and are more willing to accept harm reduction education (eg, sterile syringe access). 35,71 We controlled for history of SUD pharmacotherapy to mitigate the imbalance between the two groups during the pretreatment period.…”

Injecting network structure determines the most efficient strategy to achieve Hepatitis C elimination in people who inject drugs

“…Importantly the model does not assume any change in the behaviour in treated PWID. There is reasonable evidence to suggest that HCV treatment can be a catalyst for positive behaviour change and may be associated with fewer risk taking behaviours or the cessation of drug use altogether 37 . The extent of behaviour change following treatment requires further research.…”

Modeling hepatitis C micro-elimination among people who inject drugs with direct-acting antivirals in metropolitan Chicago

“…Access to highly efficacious direct-acting antivirals (DAAs) for PWID will be critical to achieving the World Health Organization’s (WHO) goal of reducing new chronic infections by 90% by 2030 [4]. Data from several studies have shown that DAA therapy has not increased injection risk behaviors among PWID [5-7]. Nonetheless, high uptake of DAA is expected to paradoxically increase HCV incidence initially even with stable or decreased risk behaviors due to a temporary increase in the pool of PWID susceptible to reinfection [8].…”

“…Access to and uptake of highly efficacious direct-acting antivirals (DAAs) for U.S. PWID remains low despite evidence supporting PWID can be successfully treated for HCV with sustained virologic response (SVR) similar to non-PWID [3]. Moreover, data from recent studies have shown that DAA therapy does not increase injection risk behaviors among PWID [4]–[6]; paradoxically, high uptake of DAA is expected to increase HCV incidence initially even with stable or decreased risk behaviors due to a temporary increase in the pool of PWID susceptible to reinfection [7]. DAA treatment is critical to achieving the World Health Organization’s (WHO) goal of reducing incident chronic infections by 90% by 2030 [8].…”