People Who Inject Drugs and have tuberculosis: Opioid Substitution Therapy improves treatment outcomes in Ukraine

• Published in: Journal of infection in developing countries 2021-09, Vol.15 (9.1), p.51S-57S
• Main Authors: Fomenko, Tetiana, Meteliuk, Anna, Korinchuk, Larysa, Denisiuk, Olga, Aslanyan, Garry, Islam, Zahedul, Zachariah, Rony
• Format: Article
• Language: English
• Subjects: Adult; Analgesics, Opioid; Clinical outcomes; Drug resistance; Female; Humans; Male; Middle Aged; Narcotic Antagonists - therapeutic use; Narcotics; Opiate Substitution Treatment - methods; Retrospective Studies; Substance Abuse, Intravenous - drug therapy; Substance Abuse, Intravenous - epidemiology; Success; Treatment Outcome; Tuberculosis; Tuberculosis, Pulmonary - epidemiology; Ukraine - epidemiology
• ISSN: 1972-2680; 2036-6590; 1972-2680
• DOI: 10.3855/jidc.13759

Opioid substitution therapy (OST) is one of the pillars of harm reduction strategies for People Who Inject Drugs (PWID). It should be an integral part of tuberculosis (TB) care to increase the uptake, compliance and effectiveness of treatment and also curtail risk behaviors. We aimed to compare TB treatment outcomes in relation to OST among PWID in six regions of Ukraine. A retrospective cohort study using routine programmatic data from centers offering integrated TB and OST (December 2016 - May 2020). OST involved use of methadone or buprenorphine. TB treatment outcomes were standardized. Of 228 PWID (85% male) diagnosed with TB, 104 (46%) had drug-sensitive and 124 (64%) drug-resistant TB. The majority had pulmonary TB (95%), 64 (28%) were HCV-positive and 179 (78%) were HIV-positive, 91% of the latter were also on antiretroviral therapy. There were 114 (50%) PWID with TB on OST. For drug-sensitive TB (n=104), treatment success was significantly higher (61%) in those on adjunctive OST than those not on OST (42%, P