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Heroin Addiction and Related Clinical Problems: 2020, 22, N3 (pages: 5 - 11)

Hepatitis C Related Mortality in a Cohort of Drug Users in Flanders

De Ryck H., and Matheï C.

Summary: Background. Illegal drug use has increased in Europe over the past decades, alongside the overall drug-related mortality. In Flanders, both overall and HCV-related mortality are relatively understudied. Aim. The present study has aimed to estimate the mortality rate in a group of people who use drugs (PWUD) while currently in treatment, and to compare that with the rate for the general population. More importantly, it focused specifically on the impact of chronic hepatitis C infection on mortality in PWUD. Methods. This retrospective study is based on data concerning 2,834 drug users in follow-up at the Free Clinic in Antwerp. Mortality rates were calculated and compared with a Flemish reference population. Afterwards, mortality was analysed in function of hepatitis C status, by applying bivariate and survival analyses. Results. The mortality rates obtained for PWUD were consistently higher than the average for the Flemish reference population. Higher age and Belgian nationality were associated with a higher mortality rate. In terms of the impact of HCV status, the analyses could only prove a lower mortality rate for cured patients, suggesting a positive effect on mortality by treating PWUD with chronic HCV infection. While not statistically significant, the data also seemed to indicate a higher mortality rate in chronically infected patients. Conclusions. This study provides the first available data in Belgium on mortality in a population of drug users. In order to obtain more meaningful conclusions about the effects of HCV on mortality, more studies with larger numbers of patients and a longer follow-up are needed. Furthermore, more research confirming the long-term positive effects of antiviral treatment is necessary.