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Uptake of hepatitis C virus screening and treatment in persons under opioid substitution therapy between 2008 and 2013 in Belgium

Journal Volume 84 - 2021
Issue Fasc.2 - Original articles
Author(s) D. Busschots 1 2, A. Arain 1 2, R. Bielen 1 2, Ö.M. Koc 1 2 3, L. Bruckers 4, T. Rakhmawati 4, K. Corten 1, C. Lebbe 5, K. Cornelis 6, C. Mathei 7 8, F. Buntinx 9, N. Hens 4 10, G. Robaeys 1 2 11
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PAGES 311-316
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DOI10.51821/84.2.311
Affiliations:
(1) Faculty of Health and Life Sciences, University Hasselt, Diepenbeek, Belgium
(2) Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
(3) Medical Microbiology, School of NUTRIM, Maastricht University Medical Centre, Maastricht, the Netherlands
(4) Faculty of Science, Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
(5) Medical Direction, Christian Health Insurance Fund (CM), Brussels, Belgium
(6) Department of Research and Development, Christian Health Insurance Fund (CM), Brussels, Belgium
(7) Free Clinic, Antwerp, Belgium
(8) Department of Public Health and Primary Care KULeuven, Leuven, Belgium
(9) Department of General Practice, KU Leuven, Belgium and Maastricht University, The Netherlands
(10) Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
(11) Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium

Background: Hepatitis C is a viral infection caused by the hepatitis C virus (HCV) with people who inject drugs as the main group at risk worldwide.

Aim: This study investigated the differences in uptake for HCV screening and treatment between persons in opioid substitution therapy (OST) and the other members of the Christian Health Insurance Fund in Belgium.

Methods: Invoice data were retrospectively collected from the Christian Health Insurance Fund, representing 42% of the healthcare users. Information on demographics, screening, diagnostic tests, treatment and disease progression was obtained from 2008 till 2013. All people in this study were aged 20-65 year. Persons in the OST group were identified as having at least one prescription reimbursed for methadone. This group was compared to the other members of the Insurance Fund not on OST (NOST).

Results: The Insurance Fund registered 8,409 unique OST and 3,525,190 members in the general group. HCV RNA screening rate was higher in the OST group after correction for age and gender (4.3% vs. 0.2%). Ribavirin reimbursement, did not differ between the OST and NOST group screened for HCV RNA (16.9% vs. 14.4%), though the probability of having ribavirin reimbursed was smaller for females than for males. Procedures concerning disease progression were reimbursed less frequently in the HCV RNA screened OST group compared to the NOST group (0.3% vs. 1.2%).

Conclusion: People on OST were screened more often for HCV RNA. However, the general uptake for HCV screening and treatment in both populations remained suboptimal.

Keywords: hepatitis c, substitution treatment, ribavirin, Belgium.

© Acta Gastro-Enterologica Belgica.