Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C prevention

Andreea Adelina Artenie, Elise Roy, Geng Zang, Didier Jutras-Aswad, Jean Bamvita, Svetlana Puzhko, Mark DANIEL, Julie Bruneau

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background
Meaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP).

Methods
A prospective cohort study, HEPCO, was conducted among active PWID in Montréal (2004–2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood samples for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence.

Results
At baseline assessment, of 226 participants (80.5% male; median age: 30.6 years), 37.2% reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95% confidence interval (CI): 14.0–21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95% CI: 0.31–0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection.

Conclusion
Among PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention
Original languageEnglish
Pages (from-to)970-975
Number of pages6
JournalInternational Journal of Drug Policy
Volume26
Issue number10
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Primary Care Physicians
Hepatitis C
Hepacivirus
Primary Health Care
Pharmaceutical Preparations
Needle-Exchange Programs
Virus Diseases
Seroconversion
Incidence
Confidence Intervals
Interviews
Harm Reduction
Injections
Hepatitis C Antibodies
Cocaine
Opioid Analgesics
Antiviral Agents
Prescriptions
Cohort Studies
Prospective Studies

Cite this

Artenie, Andreea Adelina ; Roy, Elise ; Zang, Geng ; Jutras-Aswad, Didier ; Bamvita, Jean ; Puzhko, Svetlana ; DANIEL, Mark ; Bruneau, Julie. / Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C prevention. In: International Journal of Drug Policy. 2015 ; Vol. 26, No. 10. pp. 970-975.
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abstract = "BackgroundMeaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP).MethodsA prospective cohort study, HEPCO, was conducted among active PWID in Montr{\'e}al (2004–2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood samples for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence.ResultsAt baseline assessment, of 226 participants (80.5{\%} male; median age: 30.6 years), 37.2{\%} reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95{\%} confidence interval (CI): 14.0–21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95{\%} CI: 0.31–0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection.ConclusionAmong PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention",
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Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C prevention. / Artenie, Andreea Adelina; Roy, Elise; Zang, Geng; Jutras-Aswad, Didier; Bamvita, Jean; Puzhko, Svetlana; DANIEL, Mark; Bruneau, Julie.

In: International Journal of Drug Policy, Vol. 26, No. 10, 2015, p. 970-975.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C prevention

AU - Artenie, Andreea Adelina

AU - Roy, Elise

AU - Zang, Geng

AU - Jutras-Aswad, Didier

AU - Bamvita, Jean

AU - Puzhko, Svetlana

AU - DANIEL, Mark

AU - Bruneau, Julie

PY - 2015

Y1 - 2015

N2 - BackgroundMeaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP).MethodsA prospective cohort study, HEPCO, was conducted among active PWID in Montréal (2004–2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood samples for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence.ResultsAt baseline assessment, of 226 participants (80.5% male; median age: 30.6 years), 37.2% reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95% confidence interval (CI): 14.0–21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95% CI: 0.31–0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection.ConclusionAmong PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention

AB - BackgroundMeaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP).MethodsA prospective cohort study, HEPCO, was conducted among active PWID in Montréal (2004–2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood samples for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence.ResultsAt baseline assessment, of 226 participants (80.5% male; median age: 30.6 years), 37.2% reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95% confidence interval (CI): 14.0–21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95% CI: 0.31–0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection.ConclusionAmong PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention

KW - Drug use

KW - Hepatitis C

KW - Injection

KW - Physician

KW - Prevention

KW - Primary care

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DO - 10.1016/j.drugpo.2015.04.013

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VL - 26

SP - 970

EP - 975

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

IS - 10

ER -