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The effect of needle and syringe program and opioid agonist therapy on the risk of HIV, hepatitis B and C virus infection for people who inject drugs in Amsterdam, the Netherlands: findings from an emulated target trial.

التفاصيل البيبلوغرافية
العنوان: The effect of needle and syringe program and opioid agonist therapy on the risk of HIV, hepatitis B and C virus infection for people who inject drugs in Amsterdam, the Netherlands: findings from an emulated target trial.
المؤلفون: van Santen DK; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, the Netherlands.; Department of Disease Elimination, Burnet Institute, Melbourne, VIC, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Boyd A; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, the Netherlands.; Stichting HIV Monitoring, Amsterdam, the Netherlands., Matser A; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, the Netherlands., Maher L; The Kirby Institute for Infection and Immunity, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia., Hickman M; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Lodi S; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA., Prins M; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, the Netherlands.; Department of Infectious Diseases, Amsterdam Infection and Immunity Institute (AIandII), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
المصدر: Addiction (Abingdon, England) [Addiction] 2021 Nov; Vol. 116 (11), pp. 3115-3126. Date of Electronic Publication: 2021 May 03.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Wiley-Blackwell
Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993-
مواضيع طبية MeSH: HIV Infections*/epidemiology , HIV Infections*/prevention & control , Hepatitis B*/epidemiology , Hepatitis B*/prevention & control , Pharmaceutical Preparations* , Virus Diseases*, Analgesics, Opioid ; Humans ; Netherlands/epidemiology ; Syringes
مستخلص: Background and Aims: Major declines in HIV and hepatitis C and B virus (HCV/HBV) incidence among people who inject drugs (PWID) have been attributed to early implementation of harm-reduction programs (HRP) in the Netherlands, but alternative factors such as selective mortality and demographic and drug market shifts over time probably contributed to observed incidence declines. We quantified and tested the effect of HRP participation on risk of these infections among PWID in Amsterdam, the Netherlands.
Design: We emulated the design of a hypothetical, ideal randomized trial using observational data from the Amsterdam Cohort Studies (1985-2014).
Setting: Amsterdam, the Netherlands.
Participants: We included PWID who ever used opioids, had a recent history of injecting drug use (IDU) and tested negative for HIV, HCV or HBV. Of 983 participants, 640, 137 and 308 were included for the HIV, HCV and HBV analyses and 59, 45 and 49 seroconversions were observed, respectively.
Interventions: Intervention arms were: complete HRP participation [≥ 60 mg/day methadone and 100% needle and syringe program (NSP) coverage, or any methadone dose if no recent injection drug use] versus no HRP and partial HRP participation combined (< 60 methadone mg/day and/or < 100% NSP coverage).
Conclusions: Complete participation in harm reduction programs appears to have led to substantial decreases in HIV and hepatitis C and B virus acquisition risk among people who inject drugs in the Netherlands.
Measurements: Separately for each infection, we estimated the hazard ratios (HR) comparing HRP arms using marginal structural models.
Findings: Compared with no/partial HRP participation, complete HRP participation led to lower risk of HIV [HR = 0.54, 95% confidence interval (CI) = 0.27-1.08], HCV (HR = 0.16, 95% CI = 0.06-0.40) and HBV (HR = 0.28, 95% CI = 0.13-0.61) acquisition.
(© 2021 Society for the Study of Addiction.)
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فهرسة مساهمة: Keywords: HIV; harm reduction programs; hepatitis B; hepatitis C; needle and syringe programs; opioid agonist therapy; people who inject drugs
المشرفين على المادة: 0 (Analgesics, Opioid)
0 (Pharmaceutical Preparations)
تواريخ الأحداث: Date Created: 20210331 Date Completed: 20211008 Latest Revision: 20240320
رمز التحديث: 20240320
DOI: 10.1111/add.15503
PMID: 33788326
قاعدة البيانات: MEDLINE
الوصف
تدمد:1360-0443
DOI:10.1111/add.15503