Historique
Article de Périodique
The impact of methadone maintenance therapy on hepatitis C incidence among illicit drug users (2014)
Auteur(s) :
NOLAN, S. ;
DIAS LIMA, V. ;
FAIRBAIRN, N. ;
KERR, T. ;
MONTANER, J. ;
GREBELY, J. ;
WOOD, E.
Année
2014
Page(s) :
2053-2059
Langue(s) :
Anglais
Refs biblio. :
47
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus géographique
CANADA
Thésaurus mots-clés
HEPATITE
;
USAGER
;
INCIDENCE
;
TRAITEMENT DE MAINTENANCE
;
METHADONE
;
ETUDE PROSPECTIVE
;
FACTEUR DE PROTECTION
Note générale :
Commentary: Opiate substitution treatment and hepatitis C virus prevention: building an evidence base? Vickerman P., Page K., Maher L., Hickman M., p. 2060-2061.
Résumé :
Aims: To determine the relationship between methadone maintenance therapy (MMT) and hepatitis C (HCV) seroconversion among illicit drug users.
Design: A generalized estimating equation model assuming a binomial distribution and a logit-link function was used to examine for a possible protective effect of MMT use on HCV incidence.
Setting: Data from three prospective cohort studies of illicit drug users in Vancouver, Canada between 1996 and 2012.
Participants: A total of 1004 HCV antibody-negative illicit drug users stratified by exposure to MMT.
Measurements: Baseline and semi-annual HCV antibody testing and standardized interviewer-administered questionnaire soliciting self-reported data relating to drug use patterns, risk behaviors, detailed socio-demographic data and status of active participation in an MMT program.
Findings: One hundred and eighty-four HCV seroconversions were observed for an HCV incidence density of 6.32 [95% confidence interval (CI) = 5.44-7.31] per 100 person-years. After adjusting for potential confounders, MMT exposure was protective against HCV seroconversion [adjusted odds ratio (AOR) = 0.47; 95% CI = 0.29-0.76]. In subanalyses, a dose-response protective effect of increasing MMT exposure on HCV incidence (AOR = 0.87; 95% CI = 0.78-0.97) per increasing 6-month period exposed to MMT was observed.
Conclusion: Participation in methadone maintenance treatment appears to be highly protective against hepatitis C incidence among illicit drug users. There appears to be a dose-response protective effect of increasing methadone exposure on hepatitis C incidence.
Design: A generalized estimating equation model assuming a binomial distribution and a logit-link function was used to examine for a possible protective effect of MMT use on HCV incidence.
Setting: Data from three prospective cohort studies of illicit drug users in Vancouver, Canada between 1996 and 2012.
Participants: A total of 1004 HCV antibody-negative illicit drug users stratified by exposure to MMT.
Measurements: Baseline and semi-annual HCV antibody testing and standardized interviewer-administered questionnaire soliciting self-reported data relating to drug use patterns, risk behaviors, detailed socio-demographic data and status of active participation in an MMT program.
Findings: One hundred and eighty-four HCV seroconversions were observed for an HCV incidence density of 6.32 [95% confidence interval (CI) = 5.44-7.31] per 100 person-years. After adjusting for potential confounders, MMT exposure was protective against HCV seroconversion [adjusted odds ratio (AOR) = 0.47; 95% CI = 0.29-0.76]. In subanalyses, a dose-response protective effect of increasing MMT exposure on HCV incidence (AOR = 0.87; 95% CI = 0.78-0.97) per increasing 6-month period exposed to MMT was observed.
Conclusion: Participation in methadone maintenance treatment appears to be highly protective against hepatitis C incidence among illicit drug users. There appears to be a dose-response protective effect of increasing methadone exposure on hepatitis C incidence.
Affiliation :
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
Cote :
Abonnement