Health-Related Quality of Life in Previous Versus Current Opiate Users Receiving HCV Therapy: Registry-Based Evidence

Background: Health and social outcomes of previous opiate users (POUs) are not well-documented. We characterize the life situation, health status, and health-related quality of life (HRQoL) of POUs entering antiviral hepatitis C (HCV) treatment, compared with HCV patients without past illicit opiate use (NOU), and with HCV patients currently in opiate agonist treatment (OAT). Methods: Data are taken from the German Hepatitis C-Registry ("Deutsches Hepatitis C-Register", DHCR), a multi-centre registry study focussing on the course and outcome of HCV treatment with directly acting antivirals. At treatment entry, patients underwent a standardized clinical assessment, including the Short Form 36 (SF-36) for self-reported HRQoL. Results: POUs (n = 734) and OAT patients (n = 554) were similar with regard to age, sex, migrant background, and psychiatric comorbidity. Employment rate and cannabis, alcohol, and smoking abstinence rates were higher for POUs than for OAT patients, but still lower than for NOU (n = 4147) patients. Mental and physical HRQoL was better for POUs than for OAT patients, but worse than for NOU patients. Compared with SF-36 normative data, POUs showed decreased HRQoL, especially regarding mental health. Conclusions: Compared with opiate-dependent patients in OAT, POUs showed less psychotropic substance use and better HRQoL. Compared with NOU patients and the general population, mental health problems were especially increased. Challenges persist for POUs even during abstinence from opiates, highlighting the need for targeted interventions tailored to the specific needs of this population.