Clinical and epidemiological characteristics of hepatitis C virusinfected people who inject drugs: a Greek descriptive analysis

Hariklia Kranidioti; Christina Chatzievagelinou; Adonis Protopapas; Margarita Papatheodoridi; Konstantinos Zisimopoulos; Eftychia Evangelidou; Pinelopi Antonakaki; John Vlachogianakos; Christos Triantos; Ioannis Elefsiniotis; John Goulis; Maria Mela; Olga Anagnostou; Christos Tsoulas; Melanie Deutsch; George Papatheodoridis; Spilios Manolakopoulos

Authors Hariklia Kranidioti, Christina Chatzievagelinou, Adonis Protopapas, Margarita Papatheodoridi, Konstantinos Zisimopoulos, Eftychia Evangelidou, Pinelopi Antonakaki, John Vlachogianakos, Christos Triantos, Ioannis Elefsiniotis, John Goulis, Maria Mela, Olga Anagnostou, Christos Tsoulas, Melanie Deutsch, George Papatheodoridis, Spilios Manolakopoulos.

Abstract

Background It is estimated that 17,000 people who inject drugs (PWID) in Greece have hepatitis C virus (HCV) viremia. The aim of our study was to explore the characteristics of the HCVinfected, direct acting antiviral (DAA)-naïve PWID.

Methods This is a retrospective analysis of PWID with HCV infection. We selected data from six liver clinics during the period from 1st May 2014 to 31st May 2017 in order to record the characteristics of infected PWID.

Results We included 800 PWID with HCV infection (78.5% male, mean age 42±10 years) who had not received DAAs before 1st June 2017. One third of the patients had comorbidities (diabetes mellitus, arterial hypertension and psychological disorders); 70% were smokers, 27% alcohol users, 67% unemployed, 29% married, and 34% had education >12 years; 65% were attending addiction programs; 57% were receiving methadone and 36% buprenorphine. Sporadic or systemic drug use was reported by 37% while 1.4% and 2.9% had HIV and HBV coinfection, respectively. The genotype distribution was 20.5%, 4.6%, 3.3%, 61% and 10% for genotypes 1a, 1b, 2, 3 and 4, respectively. Mean (±SD) liver stiffness was 9±7 kPa and 21% of the patients had cirrhosis. Half of the patients were in the F0-F1 stage of liver disease, defined as stiffness ≤7 kPa.

Conclusions Our real-life data suggest that HCV genotype 3 remains the predominant genotype among PWID. One third of PWID had comorbidities and one-fifth cirrhosis. Half of PWID had earlystage liver disease and remained without access to DAAs according to the Greek prioritization criteria.

Keywords Hepatitis C virus infection, people who inject drugs, illicit drug use

Ann Gastroenterol 2018; 31 (5): 598-603