Title :

Untreated alcohol use disorder in people who inject drugs (pwid) in france: a major barrier to hcv treatment uptake (the anrs-fantasio study)

Author(s) :

Barre, Tangui [Auteur]
Marcellin, Fabienne [Auteur]
Di Beo, Vincent [Auteur]
Delorme, Jessica [Auteur]
Rojas Rojas, Teresa [Auteur]
Mathurin, Philippe [Auteur]
Protopopescu, Camelia [Auteur]
Bailly, Francois [Auteur]
Coste, Marion [Auteur]
Authier, Nicolas [Auteur]
Carrieri, Maria Patrizia [Auteur]
Rolland, Benjamin [Auteur]

Journal title :

Addiction (Abingdon, England)

Abbreviated title :

Addiction

Publication date :

2019-10-08

ISSN :

1360-0443

English keyword(s) :

hepatitis C virus treatment
direct-acting antivirals
Alcohol use disorder
AUD treatment
people who inject drugs
France

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Although people who inject drugs (PWID) are the core at-risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, ...
Show more >Although people who inject drugs (PWID) are the core at-risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, has been identified as a barrier to HCV treatment uptake in the general population. We investigated whether the arrival of new and well-tolerated HCV treatments (direct-acting antivirals: DAA) has improved HCV treatment uptake in French PWID compared with former treatments (pegylated interferon-based treatments: Peg-IFN). Using discrete-time Cox proportional hazards models based on exhaustive care delivery data, we tested for associations between AUD (defined by AUD-related long-term illness status, diagnosis coding during hospitalization and/or AUD pharmacological treatment) and first HCV treatment delivery, after adjusting for gender, age, complementary universal health cover, liver disease severity and type of opioid agonist therapy (OAT) received. Separate analyses were performed for 2012-13 (Peg-IFN era) and 2014-16 (DAA era). France. All French people chronically HCV-infected who received OAT at least once during 2012-16 and were covered by the national health insurance (n = 24 831). Incidence rate of HCV treatment uptake, hazard ratios associated with AUD and other covariates. Incidence rate (IR) of HCV treatment uptake per 100 person-years was 6.56, confidence interval (CI) = 6.30-6.84; and IR = 5.70, 95% CI = 5.51-5.89 for Peg-IFN-based treatment (2012-13) and DAA (2014-16), respectively. After multiple adjustment, people with AUD not receiving related medication had 30 and 14% lower Peg-IFN-based treatment and DAA uptake, respectively, than those without AUD [hazard ratio (HR) = 0.70, 95% CI = 0.62-0.80 and HR = 0.86, 95% CI = 0.78-0.94]. No difference was observed between those treated for AUD and those without AUD. Despite the benefits of direct-acting antiviral treatment, untreated alcohol use disorder appears to remain a major barrier to hepatitis C virus treatment access for people who inject drugs in France.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

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

Submission date :

2024-01-30T10:28:03Z