Dataset Information

Drug-related deaths in a population-level cohort of people living with and without hepatitis C virus in British Columbia, Canada.

ABSTRACT:

Background

The majority of new HCV infections in Canada occur in people who inject drugs. Thus, while curative direct antiviral agents (DAAs) herald a promising new era in hepatitis C virus (HCV) treatment, improving the lives and wellbeing of people living with HCV (PLHCV) must be considered in the context of reducing overdose-related harms and with a syndemic lens. We measure drug-related deaths (DRDs) among HCV-negative people and PLHCV in British Columbia (BC), Canada, and the impact of potent contaminants like fentanyl on deaths.

Methods

We identified DRDs among PLHCV and HCV-negative individuals from 2010 to 2018 in the BC Hepatitis Testers Cohort, a population-based dataset of ~1.7 million British Columbians comprising comprehensive administrative and clinical data. We estimated annual standardized liver- and drug-related mortality rates per 100,000 person-years (PY) and described the contribution of specific drugs, including fentanyl and its analogues, implicated in DRDs over time.

Results

DRDs constituted 20.1% of deaths among PLHCV and 4.7% of deaths among HCV-negative individuals; a 4.3-fold (95% confidence interval: 4.0-4.5) difference. Drug-related mortality overtook liver-related mortality for PLHCV in 2015 and HCV-negative individuals in 2016 and rose from 241.7 to 436.5 per 100,000 PY from 2010 to 2018 amongPLHCV and from 20.0 to 57.1 per 100,000 PY for HCV-negative individuals over the same period. The proportion of deaths attributable to drugs among PLHCV and HCV-negative individuals increased from 15.1% to 26.1% and 3.1% to 8.0%, in 2010 and 2018, respectively. The proportion of DRDs attributed solely to synthetic opioids such as fentanyl averaged across both groups increased from 2.1% in 2010 to 69.6% in 2017.

Conclusion

Steep drug-related mortality increases among PLHCV and HCV-negative individuals over the last decade highlight the urgent need to address overdose-related drivers and harms in these populations using an integrated care approach.

SUBMITTER: Samji H

PROVIDER: S-EPMC7569420 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Drug-related deaths in a population-level cohort of people living with and without hepatitis C virus in British Columbia, Canada.

Samji Hasina H Yu Amanda A Wong Stanley S Wilton James J Binka Mawuena M Alvarez Maria M Bartlett Sofia S Pearce Margo M Adu Prince P Jeong Dahn D Clementi Emilia E Butt Zahid Z Buxton Jane J Gilbert Mark M Krajden Mel M Janjua Naveed Z NZ

The International journal on drug policy 20201019

<h4>Background</h4>The majority of new HCV infections in Canada occur in people who inject drugs. Thus, while curative direct antiviral agents (DAAs) herald a promising new era in hepatitis C virus (HCV) treatment, improving the lives and wellbeing of people living with HCV (PLHCV) must be considered in the context of reducing overdose-related harms and with a syndemic lens. We measure drug-related deaths (DRDs) among HCV-negative people and PLHCV in British Columbia (BC), Canada, and the impact ...[more]

PMID: 33091735

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Dataset Information

Drug-related deaths in a population-level cohort of people living with and without hepatitis C virus in British Columbia, Canada.

Background

Methods

Results

Conclusion

Publications

Drug-related deaths in a population-level cohort of people living with and without hepatitis C virus in British Columbia, Canada.

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