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Variation in the Viral Hepatitis and HIV Policies and Practices of Methadone Maintenance Programs

Amy B Jessop1, Jeffrey K Hom, Monika Burke

  • 1HepTREC at University of the Sciences (ABJ, MB); Department of Medicine, Crescenz VA Medical Center (JKH); Robert Wood Johnson Foundation Clinical Scholars Program (JKH); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA (JKH).

Journal of Addiction Medicine
|March 3, 2017
PubMed
Abstract

Insights

Methadone maintenance treatment (MMT) programs show limited hepatitis B, C, and HIV testing despite high infection rates. Audits revealed inconsistent practices, highlighting the need for better guidance and resources to improve screening in MMT settings.

Area of Science:

  • Infectious Disease Epidemiology
  • Public Health Policy

Background:

  • Patients in methadone maintenance treatment (MMT) have a higher prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV.
  • Despite recommendations, screening for these infections within MMT programs is not consistently implemented.

Purpose of the Study:

  • To audit and compare infection-related policies and practices in Philadelphia MMT programs between 2010 and 2015.
  • To assess the uptake and consistency of HBV, HCV, and HIV testing and hepatitis vaccination in MMT programs.

Main Methods:

  • A comparative audit of infection-related policies and practices was conducted in 14 MMT programs in Philadelphia in 2015, with data compared to a 2010 audit.
  • The audit focused on patient testing, timing, frequency, specific tests, vaccination status, and results communication.

Main Results:

  • Written policies lacked specific guidance for testing. Hepatitis C virus antibody testing was universal for new patients, but retesting varied. Hepatitis B virus testing increased but remained inconsistent.
  • Hepatitis vaccination assessment was low, with minimal administration. HIV testing declined significantly in 2015 due to the discontinuation of a city-sponsored program.

Conclusions:

  • MMT programs are crucial for identifying chronic infections but require enhanced guidance and resources to improve screening.
  • Integrating hepatitis and HIV screening into routine MMT procedures is feasible and necessary to address high infection prevalence.

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