Theme: Epidemiology & Public Health Research Year: 2024
Background: Despite the availability of curative direct-acting antivirals (DAA) for Hepatitis C virus (HCV) infection, studies show mixed results around treatment rates by gender, particularly among people who inject drugs (PWID). This analysis examines demographic differences in DAA initiation and completion rates among individuals with HCV infection who inject drugs in the United States.
Methods: Health Verity administrative claims data were used to identify continuously enrolled adults (≥18 years) with evidence of HCV from diagnostic or medication claims between 01Jan2017 and 31Dec2022 and no evidence of HIV or Hepatitis B. PWID were identified by claims for injection drug use or opioid substitution therapy. Treatment initiation was defined as ≥1 DAA claim, and treatment completion as evidence of ≥8 weeks of treatment. Unadjusted incidence rates (IR) of treatment initiation per 100 person-years with 95% confidence intervals (CIs) were calculated, stratified by age, gender, and race.
Results: Among 649,850 identified individuals with HCV, 191,674 were PWID. Of those, most were covered by Medicaid (90.9%), White (58.3%), male (54.4%), and <45 years (63.2%). Approximately 24% of the PWID population initiated DAA treatment. Female PWID had lower treatment initiation rates compared to male PWID (IRR 0.74, 95% CI 0.72- 0.76), overall and in most age and race groups, particularly 25–34-year-olds, Asians, and Hispanics. A similar proportion of female PWID completed treatment than male PWID overall (79.9% vs 80.5.%) and across age groups. Across race strata, Asian male PWID were more likely to complete treatment than Asian female PWID (84.1% vs. 73.8%, respectively); less notable differences across gender were observed in other race categories.
Conclusion: Female PWID with HCV are initiating DAA treatment at lower rates than male PWID, with notable differences across demographic strata. These data highlight a need for gender-specific efforts to engage women who inject drugs in HCV treatment.
Download abstract Download poster