Titre : | The impact of methadone maintenance therapy on hepatitis C incidence among illicit drug users (2014) |
Auteurs : | S. NOLAN ; V. DIAS LIMA ; N. FAIRBAIRN ; T. KERR ; J. MONTANER ; J. GREBELY ; E. WOOD |
Type de document : | Article : Périodique |
Dans : | Addiction (Vol.109, n°12, December 2014) |
Article en page(s) : | 2053-2059 |
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. |
Langues: | Anglais |
Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
Mots-clés : |
Thésaurus géographique CANADAThésaurus mots-clés HEPATITE ; USAGER ; INCIDENCE ; TRAITEMENT DE MAINTENANCE ; METHADONE ; ETUDE PROSPECTIVE ; FACTEUR DE PROTECTION |
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. |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 47 |
Affiliation : | Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada |
Cote : | Abonnement |
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