Hepatitis C virus incidence among injecting drug users on opioid replacement therapy. Hallinan R, Byrne A, Amin J, Dore GJ. ANZ J Public Health 2004 28;6:576-578
Dear Colleagues,
At last there is some good news about hepatitis C. In an article published this week in the ANZ Journal of Public Health we have shown that the incidence of HCV can be kept very low in drug users who are in treatment (with methadone or buprenorphine). While much of the recent information about this virus shows continued sero-conversions as being the rule, this study shows that by using treatment consistent with established guidelines, such cases can become exceptional. In fact, it was our experience that nearly all of the few cases of sero-conversion were in patients who had had their treatment interrupted and/or had been placed in custody for a time.
Between January 1996 and July 2003 54 treatment entrants were initially HCV negative. In the study period 5 sero-conversions occurred, yielding in 131.1 person years (py), an incidence of 3.8/100 py (95% CI 1.2 – 8.9/100 py). Four sero-conversions occurred in the sub-group with interrupted opioid replacement therapy (n=20) during a total of 54.2 py, an incidence of 7.4/100 py (95% CI 2.0 – 18.9/100 py). One sero-conversion occurred in the sub-group with continuous opioid replacement therapy (n=34), during a total of 76.8 py, an incidence of 1.3/100 py (95% CI 0.03 – 7.3/100 py).
The conclusion states: “HCV incidence among IDUs receiving opioid replacement therapy in our clinic was relatively low. Those IDUs without interruptions to their treatment appeared to be at particularly low risk of HCV infection. These findings support the role of opioid replacement therapy in HCV prevention for IDUs.”
Comments by Andrew Byrne.
