{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:24:01Z","timestamp":1792682641071,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022244","name":"National Institute for Health Research Applied Research Collaboration West","doi-asserted-by":"publisher","award":["RP\u2010PG\u20100616\u201020008"],"award-info":[{"award-number":["RP\u2010PG\u20100616\u201020008"]}],"id":[{"id":"10.13039\/501100022244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Direct\u2010acting antiviral (DAA) treatment has an established positive effect on liver outcomes in people with hepatitis C infection; however, there is insufficient evidence regarding its effects on the \u2018extra\u2010hepatic\u2019 outcomes of drug\u2010related hospitalization and mortality (DRM) among people who inject drugs (PWID). We investigated associations between these outcomes and DAA treatment by comparing post\u2010treatment to baseline periods using a within\u2010subjects design to minimize selection bias concerns with cohort or case\u2013control designs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a self\u2010controlled case\u2010series study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Scotland, 1 January 2015\u201330 November 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>The study population of non\u2010cirrhotic, DAA\u2010treated PWID was identified using a data set linking Scotland's hepatitis C diagnosis, HCV clinical databases, national inpatient\/day\u2010case hospital records and the national deaths register. Three principal outcomes (drug overdose admission, non\u2010viral injecting related admission and drug\u2010related mortality) were defined using ICD codes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Self\u2010controlled case\u2010series methodology was used to estimate the relative incidence (RI) of each outcome associated with time on treatment and up to six 90\u2010day exposure risk periods thereafter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 6050 PWID were treated with DAAs in the sampling time\u2010frame. Compared with the baseline period, there was a significantly lowered risk of a drug overdose hospital admission in the second to fifth exposure risk periods only [relative incidence (RI)\u2009=\u20090.86, 95% confidence interval (CI)\u2009=\u20090.80\u20130.99; 0.89, 95% CI\u2009=\u20090.80\u20130.99; 0.86, 95% CI\u2009=\u20090.77\u20130.96; 0.88, 95% CI\u2009=\u20090.78\u20130.99, respectively]. For non\u2010viral injecting\u2010related admission, there was a reduced risk in the first, third and fourth exposure risk periods (RI\u2009=\u20090.76, 95% CI\u2009=\u20090.64\u20130.90; 0.75, 95% CI\u2009=\u20090.62\u20130.90; 0.79, 95% CI\u2009=\u20090.66\u20130.96, respectively). There was no evidence for reduced DRM risk in any period following treatment end.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among people who inject drugs in Scotland, direct\u2010acting antiviral treatment appears to be associated with a small, non\u2010durable reduction in the risk of drug\u2010related hospital admission, but not drug\u2010related mortality. Direct\u2010acting antiviral therapy, despite high effectiveness against liver disease, does not appear to offer a panacea for reducing other drug\u2010related health harms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16344","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T05:18:24Z","timestamp":1695187104000},"page":"369-378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A transient positive association between direct\u2010acting antiviral therapy for hepatitis C infection and drug\u2010related hospitalization among people who inject drugs: Self\u2010controlled case\u2010series analysis of national data"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0788-6011","authenticated-orcid":false,"given":"Scott A.","family":"McDonald","sequence":"first","affiliation":[{"name":"School of Health and Life Sciences Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Dillon","sequence":"additional","affiliation":[{"name":"School of Medicine University of Dundee  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Yeung","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6047-2400","authenticated-orcid":false,"given":"Andrew","family":"McAuley","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fraser","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Edinburgh Royal Infirmary  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon J.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-320007"},{"key":"e_1_2_9_3_1","volume-title":"Drug\u2010related deaths in Scotland in 2021","author":"National Records of Scotland (NRS)","year":"2021"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.05.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27766"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz633"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4515"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2302"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109543"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.10.024"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.11.022"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.009"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26892"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2308.170439"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2021.103286"},{"key":"e_1_2_9_17_1","unstructured":"Scottish Medicines Consortium.Advice on sofosbuvir 400mg tablet (Sovaldi\u00ae).2014. 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