Theme: Epidemiology & Public Health Research Year: 2017
People who inject drugs (PWID) are a major risk group for Hepatitis C virus (HCV) infection and thus for cirrhosis and liver cancer. There are no data in Belgium concerning mortality in PWID. We studied the association between HCV infection and mortality in PWID in Limburg, Belgium.
This is a retrospective analysis of all 631 PWID enrolled in an opiate substitution (OST) program over the course of 20 years in Limburg, Belgium. A database was completed using patient files at the OST centre and referral hospitals and structured telephone calls with the general practitioner. Mortality rates and causes were compared between PWID with and without HCV RNA positivity using multivariate analysis with Cox regression.
We included 319 patients who were followed for at least one year at the OST centre, and who had a known HCV RNA and mortality status. A chronic HCV infection was present in 100 PWID. PWID infected with HCV were significantly older (47y vs. 42y; p<0.001). Male gender was associated with chronic HCV infection (34.2% vs. 20%; p=0.027). PWID with HCV were more often immigrants than PWID without HCV (p<0.001). There were no differences in OST treatment, active drug use, or socio-economic factors such as housing, income and health insurance. There was no difference in HIV of HBV coinfection. There was no difference in problematic alcohol abuse, smoking habits, chronic lung disorders or psychiatric disorders. All-cause mortality rate was 1.33/100 person years. Using logistic regression, there was no difference in all-cause mortality rate between HCV RNA positive and negative PWID. Causes of mortality were most often intoxication (17%), accident (14%), or cardiovascular disorders (7%), but were unknown in 44%. Conclusion: There was no difference in mortality rate between PWID with and without HCV infection. Further investigation is necessary to confirm these findings.