Monday Jan 9, 2016
Highs and No Lows
Largest study of its kind included 6000 patients
Ben Haddaway, BC Centre for Disease Control
Emergency crews attend to an overdose. Voice file photo.
That was one of the findings of a new BC Centre for Disease Control (BCCDC) study published in The Lancet Gastroenterology & Hepatology. The study, Incidence, risk factors, and prevention of hepatitis C reinfection: a population-based cohort study is available online.
The BCCDC hepatitis team, using its landmark dataset - BC Hepatitis Testers Cohort (BC- HTC) conducted the study to assess the role of various interventions in preventing hepatitis C (HCV) reinfection among those injecting drugs.
The study found that receiving opioid substitution therapy and being engaged with mental health counselling services were independently associated with a significantly lower likelihood of HCV reinfection.
Among people with a history of current injection drug use, there was a 27% reduction in risk of HCV reinfection with opioid substitution therapy, and a 29% reduction in risk of reinfection with mental health counselling.
“This BC Hepatitis Testers Cohort provides us with mechanisms to monitor reinfection rates and the impact of interventions to reduce hepatitis C reinfection,” said Dr. Mel Krajden, medical head of hepatitis with the BCCDC and professor, pathology & lab medicine at UBC. “The findings support policies that encourage follow-up with people who inject drugs, and the provision of harm-reduction services to minimize hepatitis C reinfection and transmission.”
While new, highly effective anti-viral drugs can cure 95 per cent of those treated, people who engage in high risk activities such as injecting drugs remain at risk of reinfection. Because the cost of treatment is very high, reinfection is a concern among physicians and policy makers in Canada and around the world.
“Hepatitis C reinfection among people who inject drugs following treatment is a major concern,” said Dr. Naveed Janjua, senior scientist with the BCCDC and clinical associate professor, School of Population & Public Health, UBC. “The findings from this study are good news for patients, physicians and policy makers because reinfection among people who use drugs could be mitigated through harm reduction interventions such as opioid substitution therapy.”
Hepatitis C is a chronic viral infection of the liver affecting about 180 million people worldwide. Approximately one per cent of British Columbians have HCV. New cases mainly occur in people who inject drugs.
Other facts and findings:
This is the largest study of its kind and included 5,915 cases of HCV who cleared their first infection either spontaneously or after successful anti-viral therapy.
People were followed up for a median of 5.4 years.
Of those cases, 452 (8%) developed reinfection.
People who cleared their infection spontaneously without treatment, those co-infected with HIV, and injection drug users had higher risk of reinfection.
About the BC Hepatitis Testers-Cohort (BC-HTC):
The BC-HTC brings together data on laboratory test results, doctor visits, hospital stays, cancer treatment and prescription drug information for people in BC who have been tested for HCV, tuberculosis or human immunodeficiency virus (HIV). Further details on the BC-HTC are available at: http://bchtc.med.ubc.ca/
This integrated dataset provides a population level approach to monitor how British Columbians with HCV are supported across their care needs. This approach is consistent with the recent World Health Organization’s hepatitis elimination strategy.
The BC Centre for Disease Control, an agency of the Provincial Health Services Authority, provides provincial and national leadership in public health through surveillance, detection, treatment, prevention and consultation services. The Centre provides both direct diagnostic and treatment services for people with diseases of public health importance and analytical and policy support to all levels of government and health authorities. For more information, please visit www.bccdc.ca or follow us on Twitter @CDCofBC
The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca r follow us on Twitter @PHSAofBC.
For information on health services available in communities across BC, visit www.healthlinkbc.ca or call 8-1-1.
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