Department of Health Services Research, Center on Addiction, New York, NY, USA.
Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA.
Subst Use Misuse. 2021;56(2):258-263. doi: 10.1080/10826084.2020.1858106. Epub 2020 Dec 21.
Although the rapid increase in opioid use disorders (OUD) and concurrent increase in Hepatitis C virus (HCV) in the United States is well-documented, little is known about HCV testing among high-risk populations. We examine patterns of HCV testing across OUD treatment settings for individuals with OUD in New York. Using 2014 New York Medicaid claims data, we identified OUD diagnosis, OUD treatment (methadone, buprenorphine, naltrexone, other treatment (inpatient or outpatient non-medication-based psychosocial treatment, such as psychotherapy) and no treatment) utilization and HCV-testing status among beneficiaries. We performed multivariable logistic regression to identify factors associated with HCV screening across OUD treatment settings. 79,764 individuals with OUD diagnoses were identified in 2014. The prevalence of HCV screening was 32.4%, 16.2%, 20.6%, 16.8%, and 18.1% for those receiving methadone, buprenorphine, naltrexone, other treatment, and no treatment, respectively. In the adjusted logistic regression, those receiving any OUD treatment had greater odds of being screened, with the highest odds among methadone clients. Engagement in medication for OUD is associated with increased HCV testing. Findings indicate the importance of access to medication-based treatment for OUD and a need to further improve HCV screening rates.
尽管美国阿片类药物使用障碍（OUD）的迅速增加和丙型肝炎病毒（HCV）的同时增加有据可查，但对于高危人群中的 HCV 检测知之甚少。我们检查了纽约 OUD 治疗环境中 OUD 个体的 HCV 检测模式。使用 2014 年纽约医疗补助索赔数据，我们确定了 OUD 诊断、OUD 治疗（美沙酮、丁丙诺啡、纳曲酮、其他治疗（住院或门诊非药物心理社会治疗，如心理治疗）和无治疗）利用和 HCV 检测状态受益。我们进行了多变量逻辑回归，以确定 OUD 治疗环境中与 HCV 筛查相关的因素。2014 年确定了 79764 名患有 OUD 诊断的个体。接受美沙酮、丁丙诺啡、纳曲酮、其他治疗和无治疗的个体中 HCV 筛查的比例分别为 32.4%、16.2%、20.6%、16.8%和 18.1%。在调整后的逻辑回归中，接受任何 OUD 治疗的人进行 HCV 检测的可能性更大，美沙酮患者的可能性最高。接受 OUD 药物治疗与 HCV 检测增加有关。研究结果表明，获得基于药物的 OUD 治疗的重要性，以及进一步提高 HCV 筛查率的必要性。
