Continued low uptake of treatment for hepatitis C virus infection in a large community-based cohort of inner city residents
Article first published online: 20 NOV 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 8, pages 1198–1206, September 2014
How to Cite
Liver Int. 2014: 34: 1198–1206
- Issue published online: 11 AUG 2014
- Article first published online: 20 NOV 2013
- Accepted manuscript online: 27 OCT 2013 05:56AM EST
- Manuscript Accepted: 20 OCT 2013
- Manuscript Received: 5 JUL 2013
- Vancouver Coastal Health
- National Health and Medical Research Council (NHMRC)
- Centre for Research Excellence in Injecting Drug Users (CREIDU)
- National CIHR Research Training Program
- National Health and Medical Research Council Practitioner Research Fellowship
- drug use;
- hepatitis C virus;
- people who inject drugs;
- treatment uptake
Background & Aims
Despite advances in HCV treatment, recent data on treatment uptake is sparse. HCV treatment uptake and associated factors were evaluated in a community-based cohort in Vancouver, Canada.
The CHASE study is a cohort of inner city residents recruited from January 2003–June 2004. HCV status and treatment were retrospectively and prospectively determined through data linkages with provincial virology and pharmacy databases. Logistic regression analyses were used to identify factors associated with HCV treatment uptake.
Among 2913, HCV antibody testing was performed in 2405, 64% were HCV antibody-positive (n = 1533). Individuals with spontaneous clearance (18%, n = 276) were excluded. Among the remaining 1257 HCV antibody-positive participants (mean age 42, 71% male), 29% were Aboriginal. At enrolment, the majority reported recent injecting (60%) and non-injecting drug use (87%). Between January 1998 and March 2010, 6% (77 of 1257) initiated HCV treatment. In adjusted analyses, Aboriginal ethnicity [adjusted odds ratio (AOR) 0.23; 95% CI 0.10, 0.51] and crack cocaine use (AOR 0.61; 95% CI 0.37, 0.99) were associated with a decreased odds of receiving HCV treatment, while methamphetamine injecting (AOR 0.16; 95% CI 0.02, 1.18) trended towards a lower odds of receiving treatment. HCV treatment uptake ranged from 0.2 (95% CI 0.0, 0.7) per 100 person-years (PYs) in 2003 to 1.6 (95% CI 0.9, 2.6) per 100 PYs in 2009.
HCV treatment uptake remains low in this large community-based cohort of inner city residents with a high HCV prevalence and access to universal healthcare.