BC Centre for Disease Control, Vancouver, BC.
Can J Public Health. 2010 Nov-Dec;101(6):491-4. doi: 10.1007/BF03403970.
We examined methadone use among a large cohort of individuals undergoing serologic testing for hepatitis C virus (HCV) infection.
In British Columbia, community pharmacy methadone dispensations are recorded in the PharmaNet database and HCV antibody (anti-HCV) test results are recorded by the Provincial Public Reference Laboratory. Provincial HCV laboratory testing records from 1992 to 2004 were linked to methadone dispensation records from 1995-2006. We describe methadone maintenance treatment (MMT) among individuals undergoing anti-HCV testing between 1992 and 2004.
Between 1992 and 2004, 404,941 individuals were tested for anti-HCV in BC; 32,918 (8%) were positive. Overall, methadone was dispensed to 10,314 (2.5%) of individuals tested for anti-HCV; 1% of negative testers and 21% of positive testers. Of 10,314 individuals receiving methadone, 6732 (65%) had a positive anti-HCV test during the study period. Laboratory anti-HCV serostatus was known at MMT initiation in 70%; of these, 2596 (36%) were anti-HCV negative and 4638 (64%) were anti-HCV positive at first methadone dispensation. Seroconversion from anti-HCV negative to positive following MMT initiation was confirmed in 288 persons.
Methadone used in conjunction with other harm reduction initiatives can reduce the transmission of blood-borne infections among individuals who inject opiates, however many who enter the BC Methadone Program are already anti-HCV positive and others seroconvert after MMT initiation. Our data suggest there are missed prevention opportunities for MMT and other harm reduction services. Linkage of laboratory and health service data can provide a population lens to identify and evaluate potential prevention strategies.
我们研究了在接受丙型肝炎病毒（HCV）感染血清学检测的大量个体中使用美沙酮的情况。
在不列颠哥伦比亚省，社区药房的美沙酮配药记录在 PharmaNet 数据库中，省级公共参考实验室记录 HCV 抗体（抗-HCV）检测结果。1992 年至 2004 年的省级 HCV 实验室检测记录与 1995 年至 2006 年的美沙酮配药记录相链接。我们描述了 1992 年至 2004 年间接受抗-HCV 检测的个体中的美沙酮维持治疗（MMT）。
1992 年至 2004 年间，不列颠哥伦比亚省有 404941 人接受了抗-HCV 检测；其中 32918 人（8%）呈阳性。总体而言，在接受抗-HCV 检测的个体中，有 10314 人（2.5%）配给了美沙酮；阴性检测者的 1%和阳性检测者的 21%。在接受美沙酮的 10314 人中，6732 人（65%）在研究期间进行了阳性抗-HCV 检测。在 MMT 启动时已知实验室抗-HCV 血清学状态为 70%；其中，2596 人（36%）抗-HCV 阴性，4638 人（64%）首次美沙酮配药时抗-HCV 阳性。在 MMT 启动后，从抗-HCV 阴性转为阳性的血清转换在 288 人身上得到证实。
美沙酮与其他减少伤害的举措相结合，可以减少注射阿片类药物者中血源性感染的传播，但许多进入不列颠哥伦比亚省美沙酮计划的人已经抗-HCV 阳性，其他人在 MMT 启动后血清转换。我们的数据表明，MMT 和其他减少伤害服务存在被忽视的预防机会。实验室和卫生服务数据的链接可以提供一个人群视角，以确定和评估潜在的预防策略。
