|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.|
|Discipline :||MAL (Maladies infectieuses / Infectious diseases)|
Thésaurus TOXIBASEHEPATITE ; USAGER ; INCIDENCE ; TRAITEMENT DE MAINTENANCE ; METHADONE ; ETUDE PROSPECTIVE ; FACTEUR DE PROTECTION
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|