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Risk Factors Associated with HCV Among Opioid-Dependent Patients in a Multisite Study

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Abstract

We examined risk factors associated with hepatitis C virus (HCV) infection among opioid-dependent patients enrolled into medication-assisted therapy (buprenorphine or methadone) to determine factors affecting chronic infection. Patients (N = 1039) were randomized as part of a larger, multisite clinical trial sponsored by the National Drug Abuse Treatment Clinical Trials Network assessing liver function. HCV status was first assessed with an antibody screen; if positive, then current infection was determined with an antigen screen testing for detectable virus. Patients were classified as HCV negative, HCV positive but have cleared the virus, or as having chronic HCV. Logistic regression analysis was used to examine demographic and behavioral correlates of the three groups. Thirty-four percent of patients were classified with chronic infection and 14 % had evidence of prior infection with apparent clearing of the virus. Chronic infection was associated with recent injection drug use and cocaine use. Chronic HCV infection was also associated with being older and Hispanic. Age, ethnicity, and current drug use increase the likelihood of being chronically infected with HCV. Strategies targeting high risk subgroups can aid in preventing further disease escalation.

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Acknowledgments

Funding has been provided by the National Institute on Drug Abuse through Grants U10DA013045 and P30 DA016383. Thanks to the participating Nodes of the Clinical Trials Network: Pacific Region Node (Matrix Institute, Los Angeles and BAART, Turk St. Clinic, San Francisco); Western States Node (Bi-Valley Medical Clinic Inc., Sacramento and CODA Research, Portland); Delaware Valley Node (NET Steps, Philadelphia); Pacific Northwest Node (Evergreen Treatment Services, Seattle); and New England Consortium (Connecticut Counseling Centers, Waterbury and Hartford Dispensary, Hartford). NIDA had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Conflict of interest

Yih-Ing Hser received a small educational grant from Reckitt Benckiser Pharmaceuticals to support a Summer Institute on Promoting Recovery within the Changing Health Service System. Andrew Saxon has served as a speaker for Reckitt Benckiser Pharmaceuticals, is a Section Editor for UpToDate for which he receives royalties, and has served as a member of a scientific advisory board for Alkermes, Inc. Walter Ling has served as a consultant for Reckitt Benckiser Pharmaceuticals. No other financial or other possible conflicts of interest exist for authors.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Authors and Affiliations

  1. UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, USA

    M. Schulte, Y. Hser, E. Evans, L. Li, D. Huang, M. Hillhouse, C. Thomas & W. Ling

  2. Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Wy., Seattle, WA, 98108, USA

    A. Saxon

  3. Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA

    A. Saxon

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  1. M. Schulte
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  2. Y. Hser
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  3. A. Saxon
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  4. E. Evans
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  5. L. Li
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  6. D. Huang
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  7. M. Hillhouse
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  8. C. Thomas
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  9. W. Ling
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Correspondence to M. Schulte.

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Schulte, M., Hser, Y., Saxon, A. et al. Risk Factors Associated with HCV Among Opioid-Dependent Patients in a Multisite Study. J Community Health 40, 940–947 (2015). https://doi.org/10.1007/s10900-015-0016-2

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  • DOI: https://doi.org/10.1007/s10900-015-0016-2

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