Theme: Epidemiology and Public Health Research Year: 2021
Background: People who use drugs (PWUD) have high rates of hepatitis C virus (HCV) infection. This study aims to characterize the HCV cascade of care of people admitted to drug treatment in Catalonia, Spain, by main drug of consumption. Methods: Data from PWUD admitted to the 61 drug treatment centers (01/2015–12/2019) were derived and linked from three databases: The drug information System; Catalan health surveillance system; and HCV treatment registry. Results are based on main drug of consumption. The cascade was defined in four steps: diagnosis of HCV; initiation of treatment; cure and reinfection. Predictors of HCV treatment access were identified using a multivariable regression model. Results: 44,306 PWUD were admitted to treatment: 9.6% (4,265) for heroine, 45.8% (20,282) alcohol; 14.3% (6,323) cannabis; 21.2% (9,384) cocaine and 4.3% (1,889) tobacco. Overall, 9.7% (4,278) had a diagnosis of HCV, 46.6% (1,993) had started HCV treatment, 83% (1,053) were cured and 1% (8) were reinfected. HCV cascade by main drug: heroine: 47% (2,004), 51.2% (1,027), 82% (410), no reinfections; alcohol: 5% (1,094), 40% (438), 316 (84%), and 1% (4); cannabis: 3% (173), 45% (78), 90% (57), no reinfections; cocaine: 5% (471), 44% (209), 82% (121), and 2% (3); and tobacco: 5% (93), 54% (50), 40 (98%), no reinfections, respectively. In multivariable analyses, human immunodeficiency virus seropositivity, imprisonment and tobacco users were independently and positively associated with HVC treatment access (P
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