title: Injecting risk behaviours following treatment for hepatitis C virus infection among people who inject drugs: The Australian Trial in Acute Hepatitis C.
abstract: BACKGROUND
  A barrier to hepatitis C virus (HCV) treatment among people who inject drugs (PWID) has been a concern that interferon-based HCV treatment may increase injecting risk behaviours. This study evaluated recent (past month) injecting risk behaviours during follow-up among PWID that did and did not receive HCV treatment.
  
  
  METHODS
  The Australian Trial in Acute Hepatitis C (ATAHC) was a prospective study of natural history and treatment of recent HCV infection. Analyses were performed using generalized estimating equations.
  
  
  RESULTS
  Among 124 participants with a history of injecting drug use (median age 32 years), 69% were male, and 68% were treated for HCV infection. HCV treatment was not associated with an increase in recent injecting drug use (adjusted odds ratio (aOR) 1.06, 95% CI 0.93, 1.21) or recent used needle and syringe borrowing during follow-up (aOR 0.99, 95% CI 0.89, 1.08). HCV treatment was associated with a decrease in recent ancillary injecting equipment sharing during follow-up (aOR 0.85, 95% CI 0.74, 0.99). Further, among treated participants who remained in follow-up (n=24), ancillary injecting equipment sharing significantly decreased from 54% at enrolment to 17% during follow-up (P=0.012).
  
  
  CONCLUSIONS
  HCV treatment was not associated with drug use or used needle and syringe borrowing during follow-up, but was associated with decreased ancillary injecting equipment sharing during follow-up. Programs to enhance HCV assessment and treatment among PWID should be expanded, given that HCV treatment does not lead to increases in injecting risk behaviours and has previously been demonstrated to be safe and effective among PWID.
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia. Electronic address: msalehialavi@kirby.unsw.edu.au.
authors.forename: Maryam
authors.initials: M
authors.lastname: Alavi
authors.affiliation: Burnet Institute, Melbourne, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Spelman
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Gail V
authors.initials: GV
authors.lastname: Matthews
authors.affiliation: Drug Health Services, Central Clinical School (C39), University of Sydney, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Haber
authors.affiliation: Central Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Day
authors.affiliation: Kirketon Road Centre, Sydney, Australia.
authors.forename: Ingrid
authors.initials: I
authors.lastname: van Beek
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Walsh
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Yeung
authors.affiliation: Centre de Recherche, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Bruneau
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.affiliation: National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Dolan
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dore
authors.affiliation: Burnet Institute, Melbourne, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Grebely
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001315:Australia; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a
keywords: Antiviral therapy; HCV; Injecting drug use; People who inject drugs