Theme: Clinical Research Year: 2019
Background: As life expectancy among people who inject drugs (PWID) infected with HCV continues to increase due to the advent of new highly effective direct-acting antivirals, many chronic health conditions associated with cigarette smoking (e.g., cardiovascular diseases, pulmonary/respiratory conditions) have become major causes of morbidity and mortality among PWID. Thus, it is critical to identify correlates of smoking in this population in order to develop effective cessation treatments. This study aimed at evaluating rates of smoking and identifying factors associated with smoking in patients with HCV. Methods: Participants were 150 PWID who enrolled in a randomized clinical aimed at testing three intensive models for HCV. The measures collected included sociodemographics, smoking related measures, drug and alcohol use history, psychiatric and chronic health conditions, adherence rates, and HCV viral load. Assessments were conducted at baseline, during the first 12 weeks of treatment, and at 12 and 24 weeks after treatment completion. Results: Of the 150 participants who initiated treatment, 126 (84%) were cigarette smokers, and 24 (16%) were non-smokers. Cigarette smoking was associated with an increased risk of both depressive symptomatology (p=.03) and diabetes (p=.03), higher drinking intensity (p≤.000) and higher levels of alcohol-related problems (p≤.001). Most smokers (107/126) who enrolled in this study continued smoking at follow-ups. Conclusion: Our study found that the vast majority of this cohort of PWID treated for HCV were current cigarette smokers. We did not find that cigarette smoking was associated with treatment outcomes, including HCV cure or treatment retention, although we identified three correlates of cigarette smoking, namely depressive symptoms, diabetes, and both alcohol use and misuse. Given the detrimental effects that cigarette smoking and other co-occurring, unadaptive behaviors (in this study depressive symptoms, diabetes and alcohol use) have on HCV-infected individuals health, it is imperative that clinicians treating HCV also target smoking cessation. Disclosure of Interest Statement: Dr. Akiyama has served on an advisory board for Gilead Sciences outside the submitted work. Dr. Norton reports grants from Merck and Co. outside the submitted work. Dr. Litwin reports grants from Gilead Sciences during the conduct of the study, and grants and personal fees from Gilead Sciences and Merck Pharmaceuticals outside the submitted work. Authors not named here have disclosed no conflicts of interest.
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