Hepatitis C Virus Prevalence and Incidence in a Large Nationwide Sample of Patients in Opioid Substitution Treatment in Germany: A Prospective Cohort Study. (21st October 2019)

• Record Type: Journal Article
• Authors: Schulte, Bernd; Schmidt, Christiane Sybille; Strada, Lisa; Rosenkranz, Moritz; Schäfer, Ingo; Verthein, Uwe; Reimer, Jens
• Is Part Of: Clinical infectious diseases. Volume 70:Number 10(2020)
• Page Start: 2199
• Page End: 2205
• Publication Date: 2019-10-21
• Subjects: hepatitis C virus -- opioid substitution treatment -- prevalence -- incidence -- seroconversion; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz661
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Hepatitis C virus (HCV) infection is highly prevalent among people who inject drugs (PWID). Accurate data on HCV prevalence and incidence rates among patients receiving opioid substitution treatment (OST) are needed to estimate the current and future burden of HCV infections in this high-risk population. Methods: Baseline data from routine care were collected between October 2014 and June 2016 from randomly selected OST facilities in Germany. The primary outcome measure was the HCV status (antibody and RNA prevalence). Patients who were HCV antibody–negative at baseline were followed up after 12 months to calculate the HCV incidence rate. Results: Sixty-three facilities from 14 German Federal States provided clinical data for a total of 2466 OST patients. HCV antibody and HCV RNA prevalence were 58.8% (95% confidence interval [CI], 56.8%–60.8%) and 27.3% (95% CI, 25.5%–29.2%), respectively. At baseline, a total of 528 patients (21.4%) had previously undergone antiviral treatment. Moreover, lower HCV RNA prevalence was associated with female gender, employment, younger age, and shorter duration of OST and opioid dependence. The HCV incidence rate was 2.5 cases per 100 person-years. Conclusions: The low HCV RNA prevalence and HCV incidence rates confirm that OST in Germany is an effective setting both for treating chronic HCV infections and for preventing new infections among PWID. Scaling up the provision of OST, HCV testing, and HCV treatment among OST patients are important public health strategies for reducing HCV infections in this high-risk population. Abstract : This nationwide prospective cohort study supports the protective effects of opioid substitution treatment by confirming a low hepatitis C virus (HCV) RNA prevalence rate (27.3%) and low HCV incidence rate (2.5 cases per 100 person-years) among 2467 opioid-substituted patients in Germany.