Real-world hepatitis C prevalence and treatment uptake at opioid agonist therapy clinics in Ontario, Canada

B. Wolfson-Stofko*, G. Hirode, A. Vanderhoff, J. Karkada, C. Capraru, M. J. Biondi, B. Hansen, H. Shah, H. L.A. Janssen, J. J. Feld

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Widespread screening for hepatitis C virus (HCV) is necessary for Canada to meet its HCV elimination goals by 2030. People who currently or previously injected drugs are at high risk for HCV. Opioid agonist therapy (OAT, such as methadone and buprenorphine) has been shown to help stabilize the lives of people who are opioid-dependent. The distribution of OAT in North America typically requires daily, weekly, or monthly clinic visits and presents an opportunity for engagement, screening and treatment for those at high-risk of HCV. In this study, HCV screening was conducted by staff at OAT clinics in Ontario from 2016 to 2020 and those with chronic infections were treated on-site with direct-acting antivirals. Point-of-care or dried blood spot (DBS) testing was used for antibodies, DBS or serum for HCV RNA and serum for HCV RNA at SVR12 (sustained virological response). Clinics screened 1954 people (mean age 40 years ±12, 63% male). Forty-five percent were antibody positive, of whom 64% were HCV RNA+. Eighty percent of those RNA+ set an appointment in which 99% attended. Ninety-six percent started treatment with 87% completing treatment. Sixty-eight percent of people who completed treatment submitted a sample for SVR12 testing of which 97% achieved a virological cure. Results suggest that HCV screening and treatment at OAT clinics is feasible, effective and warrants expansion. Data suggest strong treatment adherence due to high rates of SVR12 comparable with other OAT-based HCV treatment programs. The lack of SVR12 sampling could be addressed by either on-site phlebotomy or incentivizing SVR12 sampling.

Original languageEnglish
Pages (from-to)240-247
Number of pages8
JournalJournal of Viral Hepatitis
Volume31
Issue number5
Early online date22 Feb 2024
DOIs
Publication statusPublished - May 2024

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Publisher Copyright: © 2024 John Wiley & Sons Ltd.

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