Injection Drug Use Patterns and Changes Associated With HCV Treatment

Author: Benjamin Eckhardt Yesenia Aponte-Melendez Chunki Fong Shashi Kapadia Melinda Pai Kristen Marks Pedro Mateu-Gelabert

Theme: Clinical Research Year: 2022

Direct activing antiviral (DAA) therapy has proven safe and effective at curing HCV infection in people
who are actively injecting drugs, with low rates of reinfection. We examine the injection drug behavior
changes that took place in a cohort of individuals treated for HCV while still reporting active injection
drug use.

Data was analyzed from the Accessible Care Trial for curing HCV in PWID, a randomized clinical trial
compared on-site, low-threshold HCV treatment with care-coordination at a NYC syringe service
program (Accessible Care) with facilitated referral to local providers through a patient navigation
program. Changes in medication for opioid use disorder (MOUD) treatment, injection frequency, and
injection equipment sharing were compared at baseline and 3-months between those who initiated DAA
therapy in the Accessible Care treatment (ACTx) arm and those who did not initiate therapy (NoTx).

Forty-four participants in the ACTx were compared to 103 participants in the NoTx arm. The mean age
of participants was 41.4 years, 22.4% were women, and 58.2% reported being homeless in the prior 3
months. Both the ACTx group and NoTx group had high rates of MOUD engagement at baseline and at 3
months. In the prior 30 days, all group saw a reduction between baseline and 3-month follow-up in
injection frequency (48% in ACtx vs 20% in NoTx), use of syringe used by someone else (95% in ACtx vs
55% in NoTx), and number of times sharing a cooker (71% in ACtx vs 2% in NoTx).

Treating people who inject drugs may also have indirect pro-health benefits including reduction
in high risk injection drug behaviors. The low rates of HCV reinfection seen in many HCV
treatment studies may be partially related to decreased injection risk behavior.

Disclosure of Interest Statement:
Benjamin Eckhardt, Kristen Marks, and Shashi Kapadia receive research grant support from Gilead
Sciences for studies not related to this abstract

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