HepCInfo Update 8.3
Welcome to CATIE's HepCInfo Update 8.3 for January 21, 2017 to February 3, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and noteworthy
Mental health counselling and opiate substitution therapy (OST) were associated with a lower risk of hepatitis C reinfection in people who were currently injecting drugs, reported researchers in the Lancet Gastroenterology and Hepatology.
The researchers analysed data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for hepatitis C or HIV at the British Columbia Centre for Disease Control Public Health Laboratory between 1990 and 2013. For the current study, researchers used data from 5915 people who had cleared hepatitis C or been cured through treatment. The mid-range of follow up time was about five and a half years.
Of this group, eight percent (462 people) were reinfected with hepatitis C. Among the 1604 participants with a current history of injecting drugs, those who took OST had 27% reduced risk of hepatitis C reinfection and those who received mental health counselling had a 29% reduced risk of hepatitis C reinfection.
According to the researchers, “the findings support policies that encourage follow-up with people who inject drugs, and the provision of harm-reduction services to minimize hepatitis C reinfection and transmission.” (bccdc.ca, January 2017)
Curing hepatitis C substantially reduces the risk of diabetes in people with both hepatitis C and HIV, reported researchers in Hepatology.
Curing hepatitis C has been shown to reduce the risk of diabetes, kidney disease, kidney failure and heart disease in people with only hepatitis C, but it is not clear whether curing hepatitis C in people co-infected with HIV and hepatitis C reduces the risk of these diseases.
This study consisted of 1625 people with hepatitis C and HIV from 19 clinics in Spain. Participants had taken interferon and ribavirin between 2000 and 2008. All participants had well controlled HIV. Thirty-eight percent of participants were cured after treatment and 2.5% were cured after re-treatment. After treatment participants were followed for a mid-range of 5.4 years.
Type 2 diabetes occurred more often in people who were not cured of hepatitis C (7.5%) than those who were cured (3.7%). The results did not show a definitive improvement in kidney problems. The results also showed a higher rate of heart disease in people who were cured of hepatitis C.
Participants who were cured of hepatitis C also had a decreased risk of death, liver-related death and AIDS-related events compared to those who were not cured.
According to the researchers, their findings support an offer of treatment to anyone with HIV and hepatitis C co-infection who has insulin resistance or type 2 diabetes, regardless of fibrosis stage. (aidsmap.com, February 2017)
Youth who used drugs but who had never injected drugs were two times more likely to start injecting drugs after being unable to access substance use treatment, reported B.C. researchers in Substance Abuse Treatment, Prevention and Policy.
The 462 participants were street-involved youth (ages 14 to 26) living in Vancouver, B.C. from the At Risk Youth Study. Each participant had used drugs in the past 30 days. To be included in the study, youth had to never have injected drugs at the start of the study and attended one follow up visit between September 2005 and May 2014.
During the study time period:
- 28% of youth tried to access substance use treatment but could not get treated
- 21% of youth injected drugs for the first time
Participants tried to access substance use treatment at detox services (41%), treatment centres (35%), recovery houses (10%) and from counsellors (4%).
Youth were unable to access treatment for the following reasons:
- Waiting lists (66%)
- Logistical barriers, including location, hours and documentation (18%)
- Behavioural issues (6%)
- Unspecified reason (9%)
The results of this study suggest that if youth who use drugs but who have never injected drugs before are able to access substance use treatment, it may reduce the likelihood that they will begin injecting drugs. Reducing barriers to substance use treatment for youth may prevent injection initiation and help to reduce drug-related harms, such as new hepatitis C and HIV infections. (catie.ca, January 2017)