Title :

Adherence to opioid agonist therapy predicts uptake of direct-acting antivirals in people who use drugs: results from the French national healthcare database (the ANRS FANTASIO study).

Author(s) :

Rolland, Benjamin [Auteur]
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center [CRNL]
Lions, Caroline [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]
Di Beo, Vincent [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]
Carrieri, Patrizia [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]
Authier, Nicolas [Auteur]
CHU Clermont-Ferrand
Barré, Tangui [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]
Delorme, Jessica [Auteur]
Mathurin, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Bailly, François [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Protopopescu, Camelia [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]
Marcellin, Fabienne [Auteur]
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD]
Institut des sciences de la santé publique [Marseille] [ISSPAM]

Journal title :

Harm Reduction Journal

Abbreviated title :

Harm Reduct J

Volume number :

19

Pages :

119

Publication date :

2022-10-29

ISSN :

1477-7517

English keyword(s) :

Methadone
Buprenorphine
Hepatitis C
DAA
Drug use

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Opioid agonist therapy (OAT) is associated with reduced injection, reduced HCV transmission, and more opportunities to initiate hepatitis C virus (HCV) treatment in people who use drugs (PWUD). We aimed to ...
Show more >Background Opioid agonist therapy (OAT) is associated with reduced injection, reduced HCV transmission, and more opportunities to initiate hepatitis C virus (HCV) treatment in people who use drugs (PWUD). We aimed to study the extent to which adherence to OAT was predictive of increased uptake of direct-acting antivirals (DAA) in PWUD with chronic HCV infection. Methods Using the French national healthcare system database, we targeted PWUD (i.e. with a history of OAT) who had chronic HCV infection and were eligible for DAA during 2014–2016. Adherence to OAT was computed as a time-varying variable expressing the proportion of days covered by OAT receipt, over any six-month interval before DAA receipt. We used a Cox proportional hazards model to estimate the association between adherence to OAT and the rate of DAA uptake after adjustment for age, sex, alcohol use disorder, socioeconomic status, and liver disease severity. Results Among the 22,615 persons included in the ANRS FANTASIO study, 3438 (15.2%) initiated DAA during the study period. After multivariable adjustment, adherence to OAT was associated with a higher rate of DAA initiation. However, this association was not linear, and only individuals on OAT for 20% or more of the time in the previous six-month period had a higher rate of DAA initiation (adjusted hazard ratio [95% confidence interval]: 1.28 [1.18–1.38]). Other variables associated with DAA initiation were male sex, older age, cirrhosis or liver cancer, and higher socioeconomic status. Conclusions Adherence to OAT is a major predictor of DAA initiation in PWUD living with chronic HCV infection in France. Our results also suggest that even moderate adherence to OAT can facilitate DAA uptake. Adequate HCV training for OAT prescribers together with interventions to ensure adherence to OAT will help improve DAA initiation rates and reach HCV elimination goals.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T00:12:06Z
2024-03-25T15:38:07Z
2024-03-25T15:39:34Z