scholarly journals Factors and HCV treatment outcomes associated with smoking among people who inject drugs on opioid agonist treatment: secondary analysis of the PREVAIL randomized clinical trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Irene Pericot-Valverde ◽  
Moonseong Heo ◽  
Matthew J. Akiyama ◽  
Brianna L. Norton ◽  
Linda Agyemang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cigarette Smoking ◽  
Treatment Outcomes ◽  
Randomized Clinical Trial ◽  
People Who Inject Drugs ◽  
Treatment Completion ◽  
Hcv Treatment ◽  
Opioid Agonist ◽  
Cocaine Use ◽  
High Prevalence

Abstract Background Cigarette smoking has emerged as a leading cause of mortality among people with hepatitis C virus (HCV). People who inject drugs (PWID) represent the largest group of adults infected with HCV in the US. However, cigarette smoking remains virtually unexplored among this population. This study aimed at (1) determining prevalence and correlates of cigarette smoking among HCV-infected PWID enrolled in opiate agonist treatment programs; (2) exploring the association of smoking with HCV treatment outcomes including adherence, treatment completion and sustained virologic response (SVR); and 3) exploring whether cigarette smoking decreased after HCV treatment. Methods Participants were 150 HCV-infected PWID enrolled in a randomized clinical trial primarily designed to test three intensive models of HCV care. Assessments included sociodemographics, presence of chronic health and psychiatric comorbidities, prior and current drug use, quality of life, and HCV treatment outcomes. Results The majority of the patients (84%) were current cigarette smokers at baseline. There was a high prevalence of psychiatric and medical comorbidities in the overall sample of PWID. Alcohol and cocaine use were identified as correlates of cigarette smoking. Smoking status did not influence HCV treatment outcomes including adherence, treatment completion and SVR. HCV treatment was not associated with decreased cigarette smoking. Conclusions The present study showed high prevalence of cigarette smoking among this population as well as identified correlates of smoking, namely alcohol and cocaine use. Cigarette smoking was not associated with HCV treatment outcomes. Given the detrimental effects that cigarette smoking and other co-occurring, substance use behaviors have on HCV-infected individuals’ health, it is imperative that clinicians treating HCV also target smoking, especially among PWID. The high prevalence of cigarette smoking among PWID will contribute to growing morbidity and mortality among this population even if cured of HCV. Tailored smoking cessation interventions for PWID along with HCV treatment may need to be put into clinical practice. Trial registration NCT01857245. Registered May 20, 2013.

scholarly journals Declines in Depressive Symptoms Among People who Inject Drugs Treated With Direct-Acting Antivirals While on Opioid Agonist Therapy

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Irene Pericot-Valverde ◽  
Moonseong Heo ◽  
Jiajing Niu ◽  
Brianna L Norton ◽  
Matthew J Akiyama ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Illicit Drugs ◽  
People Who Inject Drugs ◽  
Sustained Viral Response ◽  
Addiction Severity Index ◽  
Psychiatric Diagnoses ◽  
Direct Acting Antivirals ◽  
Hcv Treatment ◽  
Opioid Agonist ◽  
Direct Acting

Abstract Background Hepatitis C virus (HCV) frequently co-occurs with symptoms of depression, which are aggravated on interferon-based regimens. However, it is unknown whether HCV treatment with direct-acting antivirals (DAAs) has effects on depressive symptoms among people who inject drugs (PWID). In this study, we examined changes in depressive symptoms during and after HCV treatment among PWID on opioid agonist therapies (OATs). Methods Participants were 141 PWID who achieved sustained viral response after on-site HCV treatment at 3 OAT programs. Depressive symptoms were assessed using the Beck Depression Inventory–II (BDI-II) at baseline, every 4 weeks during treatment, and 12 and 24 weeks after treatment completion. Current diagnosis of depression or other psychiatric diagnoses were obtained through chart review. Use of illicit drugs was measured by urine toxicology screening. Alcohol use was measured using the Addiction Severity Index–Lite. Results Of the 141 PWID infected with HCV, 24.1% had severe, 9.9% had moderate, 15.6% had mild, and 50.4% had minimal levels of depression as per BDI-II scores at baseline. HCV treatment was significantly associated with reductions in depressive symptoms that persisted long term, regardless of symptom severity (P < .001) or presence of depression (P ≤ .01) or other psychiatric diagnoses (P ≤ .01) at baseline. Concurrent drug use (P ≤ .001) or hazardous alcohol drinking (P ≤ .001) did not interfere with reductions in depressive symptoms. Conclusions Depressive symptoms are highly prevalent among HCV-infected PWID. HCV treatment was associated with sustained reductions in depressive symptoms. HCV therapy with DAAs may have important implications for PWID that go beyond HCV cure.

scholarly journals Correction: Impact on Patients' Treatment Outcomes of XpertMTB/RIF Implementation for the Diagnosis of Tuberculosis: Follow-Up of a Stepped-Wedge Randomized Clinical Trial

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0156471
Author(s):  
Anete Trajman ◽  
Betina Durovni ◽  
Valeria Saraceni ◽  
Alexandre Menezes ◽  
Marcelo Cordeiro-Santos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Outcomes ◽  
Randomized Clinical Trial ◽  
Stepped Wedge

Citalopram for Treatment of Cocaine Use Disorder: A Bayesian Drop-The-Loser Randomized Clinical Trial

2021 ◽  
pp. 109054
Author(s):  
Robert Suchting ◽  
Charles E. Green ◽  
Constanza de Dios ◽  
Jessica Vincent ◽  
F. Gerard Moeller ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cocaine Use

scholarly journals Association between opioid agonist therapy and testing, treatment uptake, and treatment outcomes for hepatitis C infection among people who inject drugs: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Jason Grebely ◽  
Lucy Tran ◽  
Louisa Degenhardt ◽  
Alexander Dowell-Day ◽  
Thomas Santo ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
People Who Inject Drugs ◽  
Meta Analysis ◽  
Hcv Rna ◽  
Agonist Therapy ◽  
Opioid Agonist ◽  
Opioid Agonist Therapy ◽  
Treatment Uptake ◽  
Hcv Antibody ◽  
Hcv Testing

Abstract Background People who inject drugs (PWID) experience barriers to accessing testing and treatment for hepatitis C virus (HCV) infection. Opioid agonist therapy (OAT) may provide an opportunity to improve access to HCV care. This systematic review assessed the association of OAT and HCV testing, treatment, and treatment outcomes among PWID. Methods Bibliographic databases and conference presentations were searched for studies assessing the association between OAT and HCV testing, treatment, and treatment outcomes [direct-acting antiviral (DAA) therapy only] among people who inject drugs (in the past year). Meta-analysis was used to pool estimates. Results Among 9,877 articles identified, 22 studies conducted in Australia, Europe, North America, and Thailand were eligible and included. Risk of bias was serious in 21 studies and moderate in one study. Current/recent OAT was associated with an increased odds of recent HCV antibody testing [4 studies; odds ratio (OR), 1.80; 95% CI:1.36, 2.39), HCV RNA testing among those who were HCV antibody positive (2 studies; OR, 1.83; 95% CI:1.27, 2.62), and DAA treatment uptake among those who were HCV RNA positive (7 studies; OR 1.53; 95% CI: 1.07, 2.20). There was insufficient evidence of an association between OAT and treatment completion (9 studies) or sustained virologic response following DAA therapy (9 studies). Conclusions Opioid agonist therapy can increase linkage to HCV care, including uptake of HCV testing and treatment among PWID. This supports the scale-up of OAT as part of strategies to enhance HCV treatment to further HCV elimination efforts.

scholarly journals Longitudinal Findings from a Randomized Clinical Trial of Varenicline for Alcohol Use Disorder with Comorbid Cigarette Smoking

2019 ◽  
Vol 43 (5) ◽  
pp. 937-944 ◽  
Author(s):  
Krysten W. Bold ◽  
Allen Zweben ◽  
Lisa M. Fucito ◽  
Mary E. Piepmeier ◽  
Srinivas Muvvala ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Alcohol Use ◽  
Cigarette Smoking ◽  
Randomized Clinical Trial ◽  
Alcohol Use Disorder

scholarly journals A220 THE EFFECT OF HOMELESSNESS ON HCV TREATMENT OUTCOMES AMONG PEOPLE WHO INJECT DRUGS

2018 ◽  
Vol 1 (suppl_1) ◽  
pp. 384-384 ◽  
Author(s):  
A Singh ◽  
G Kiani ◽  
R Shahi ◽  
A Alimohammadi ◽  
T Raycraft ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
People Who Inject Drugs ◽  
Hcv Treatment

scholarly journals Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0177698 ◽  
Author(s):  
Surajudeen Abiola Abdulrahman ◽  
Lekhraj Rampal ◽  
Faisal Ibrahim ◽  
Anuradha P. Radhakrishnan ◽  
Hayati Kadir Shahar ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mobile Phone ◽  
Treatment Outcomes ◽  
Randomized Clinical Trial ◽  
Peer Counseling

scholarly journals Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 3: Eight-day randomized clinical trial in the UK

2012 ◽  
Vol 64 (2) ◽  
pp. S35-S44 ◽  
Author(s):  
Anthony R. Tricker ◽  
Adrian J. Stewart ◽  
Claire Martin Leroy ◽  
Dirk Lindner ◽  
Matthias K. Schorp ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cigarette Smoking ◽  
Randomized Clinical Trial ◽  
System Part ◽  
The Uk ◽  
Exposure Evaluation

scholarly journals Integrated treatment of hepatitis C virus infection among people who inject drugs: study protocol for a randomised controlled trial (INTRO-HCV)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lars T. Fadnes ◽  
◽  
Christer Frode Aas ◽  
Jørn Henrik Vold ◽  
Christian Ohldieck ◽  
...  
Keyword(s):  
Standard Care ◽  
People Who Inject Drugs ◽  
Integrated Treatment ◽  
Agonist Therapy ◽  
Hcv Treatment ◽  
Opioid Agonist ◽  
Opioid Agonist Therapy ◽  
Disorder Treatment ◽  
Randomised Controlled

Abstract Background A large proportion of people who inject drugs (PWID) living with hepatitis C virus (HCV) infection have not been treated. It is unknown whether inclusion of HCV diagnostics and treatment into integrated substance use disorder treatment and care clinics will improve uptake and outcome of HCV treatment in PWID. The aim is to assess the efficacy of integrating HCV treatment to PWID and this paper will present the protocol for an ongoing trial. Methods INTRO-HCV is a multicentre, randomised controlled clinical trial that will compare the efficacy of integrated treatment of HCV in PWID with the current standard treatment. Integrated treatment includes testing for HCV, assessing liver fibrosis with transient elastography, counselling, treatment delivery, follow-up and evaluation provided by integrated substance use disorder treatment and care clinics. Most of these clinics for PWID provide opioid agonist therapy while some clinics provide low-threshold care without opioid agonist therapy. Standard care involves referral to further diagnostics, treatment and treatment follow-up given in a hospital outpatient clinic with equivalent medications. The differences between the delivery platforms in the two trial arms involve use of a drop-in approach rather than specific appointment times, no need for additional travelling, less blood samples taken during treatment, and treatment given from already known clinicians. The trial will recruit approximately 200 HCV infected individuals in Bergen and Stavanger, Norway. The primary outcomes are time to treatment initiation and sustained virologic response, defined as undetectable HCV RNA 12 weeks after end of treatment. Secondary outcomes are cost-effectiveness, treatment adherence, changes in quality of life, fatigue and psychological well-being, changes in drug use, infection related risk behaviour, and risk of reinfection. The target group is PWID with HCV diagnosed receiving treatment and care within clinics for PWID. Discussion This study will inform on the effects of an integrated treatment program for HCV in clinics for PWID compared to standard care aiming to increase access to treatment and improving treatment adherence. If the integrated treatment model is found to be safe and efficacious, it can be considered for further scale-up. Trial registration ClinicalTrials.gov.no. NCT03155906.

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