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Hepatitis C Virus–Related Knowledge and Willingness to Receive Treatment Among Patients on Methadone Maintenance

Zeremski, Marija PhD; Dimova, Rositsa B. PhD; Zavala, Roberto MD; Kritz, Steven MD; Lin, Melissa MS; Smith, Bryce D. PhD; Zibbell, Jon E. PhD; Talal, Andrew H. MD, MPH

doi: 10.1097/ADM.0000000000000041
Original Research

Objectives: Although persons who inject drugs have high prevalence of hepatitis C virus (HCV) infection, few receive treatment mostly because of lack of knowledge about the infection and its treatment. We assessed the level of HCV-related knowledge and willingness to participate in HCV treatment among methadone-maintained patients.

Methods: A 30-item survey covering HCV-related knowledge and willingness to engage in HCV-related education and treatment was developed and completed by 320 methadone-maintained patients.

Results: Respondents' mean age was 53 ± 8.7 years, 59.5% were male, 55.1% were African American, and 38.3% were Hispanic. The mean duration of methadone maintenance was 7 ± 6.7 years. In the preceding 6 months, 6.9% of patients reported injection drug use, whereas 37.3% used noninjection drugs. Hepatitis C virus seropositivity was self-reported by 46.3% of patients. The majority of patients (78%) expressed willingness to participate in HCV-related education and to receive HCV treatment. Most patients (54.7%) correctly answered 5 or more of 7 questions assessing HCV knowledge. Hepatitis C virus–seropositive individuals and prior attendees at HCV-related educational activities demonstrated a higher level of HCV-related knowledge (P < 0.001 and P = 0.002, respectively). Younger patients (P = 0.014), those willing to attend an HCV-related educational activity (P < 0.001), and those with higher–HCV-related knowledge (P = 0.029) were more accepting of HCV treatment. Fear of medication-related side effects was the most common reason for treatment avoidance.

Conclusions: The majority of patients reported willingness to receive HCV-related education and treatment. Treatment willingness was significantly associated with previous attendance at an HCV educational activity and a higher level of HCV-related knowledge.

Supplemental Digital Content is Available in the Text.

From the Division of Gastroenterology and Hepatology (MZ, RBD, AHT), Weill Cornell Medical College, New York, NY; Department of Biostatistics (RBD), University at Buffalo, State University of New York, Buffalo, NY; Addiction Research and Treatment Corporation (RZ, SK, ML), Brooklyn, NY; Centers for Disease Control and Prevention (BDS, JEZ), Division of Viral Hepatitis, Atlanta, GA; and Division of Gastroenterology, Hepatology, and Nutrition (AHT), Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY.

Send correspondence and reprint requests to Marija Zeremski, PhD, Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1300 York Ave, Box 319, New York, NY 10065. E-mail:

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Supported by the CDC Foundation through the Viral Hepatitis Action Coalition with individual sponsorships from Gilead Sciences, Vertex Pharmaceuticals, Abbvie and Abbott Molecular Inc. Andrew H. Talal has served on the advisory board for Abbott Molecular and has received research support from Gilead Sciences. The remaining authors declare no conflicts of interest.

Received December 11, 2013

Accepted March 09, 2014

© 2014 American Society of Addiction Medicine