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.

ates of hepatitis C reinfection among people who inject drugs are significantly  reduced in those receiving opioid substitution therapy and mental health counselling.


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:


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 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  r follow us on Twitter @PHSAofBC.


For information on health services available in communities across BC, visit or call 8-1-1.


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