The efficacy of integrated hepatitis C virus treatment in relieving fatigue in people who inject drugs: A randomized controlled trial

Jørn Henrik Vold*, Fatemeh Chalabianloo, Else Marie Løberg, Christer F Aas, Aaron G Lim, Peter T Vickerman, Kjell Arne Johansson, Lars Thore Fadnes

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)


Most people who inject drugs (PWIDs) suffer from severe fatigue, and chronic hepatitis C virus (HCV) infection may play a role in this. However, there is scarce evidence about interventions that alleviate fatigue among PWIDs. The present study investigated the effect of integrated HCV treatment on fatigue in this population compared to the effect of standard HCV treatment, adjusted for sustained virological response of the HCV treatment.

This multi-center, randomized controlled trial evaluated fatigue as a secondary outcome of integrated HCV treatment (the INTRO-HCV trial). From May 2017 to June 2019, 276 participants in Bergen and Stavanger, Norway, were randomly assigned to receive integrated and standard HCV treatment. Integrated treatment was delivered in eight decentralized outpatient opioid agonist therapy clinics and two community care centers; standard treatment was delivered in specialized infectious disease outpatient clinics at referral hospitals. Fatigue was assessed prior to treatment and 12 weeks after treatment using the nine-item Fatigue Severity Scale (FSS-9). We applied a linear mixed model to evaluate the impact of integrated HCV treatment on changes in FSS-9 (ΔFSS-9) sum scores.

At baseline, the mean FSS-9 sum score was 46 (standard deviation (SD): 15) for participants on integrated HCV treatment and 41 (SD: 16) for those on standard treatment. Twelve weeks after completed HCV treatment, the mean FSS-9 sum score for participants receiving integrated HCV treatment was 42 (SD: 15) and 40 (SD: 14) for those receiving standard HCV treatment. Integrated HCV treatment did not reduce the FSS-9 scores compared to standard HCV treatment (ΔFSS-9: -3.0, 95% confidence interval (CI): -6.4;0.4).

Fatigue is a common symptom among PWIDs. Integrated HCV treatment is at least equal to standard HCV treatment in improving fatigue.

Trial registration NCT03155906, 16/05/2017.
Original languageEnglish
Article number25
JournalSubstance abuse treatment, prevention, and policy
Issue number1
Publication statusPublished - 24 Apr 2023

Bibliographical note

Funding Information:
We thank Nina Elisabeth Eltvik, Christer Kleppe, Rafael Alexander Leiva, and Christian Ohldieck for valuable help and input during the planning and preparation phases. We also thank the INTRO-HCV Study Group for important contribution relating to data collection. INTRO-HCV Study Group participating investigators: Bergen: Christer Frode Aas, Vibeke Bråthen Buljovcic, Fatemeh Chalabianloo, Jan Tore Daltveit, Silvia Eiken Alpers, Lars T. Fadnes (principal investigator), Trude Fondenes Eriksen, Per Gundersen, Velinda Hille, Kristin Holmelid Håberg, Kjell Arne Johansson, Rafael Alexander Leiva, Siv-Elin Leirvåg Carlsen, Martine Lepsøy Bonnier, Lennart Lorås, Else-Marie Løberg, Mette Hegland Nordbotn, Cathrine Nygård, Maria Olsvold, Christian Ohldieck, Lillian Sivertsen, Hugo Torjussen, Jørn Henrik Vold, Jan-Magnus Økland Stavanger: Tone Lise Eielsen, Nancy Laura Ortega Maldonado, Ewa Joanna Wilk proLAR: Ronny Bjørnestad, Ole Jørgen Lygren, Marianne Cook Pierron Oslo: Olav Dalgard, Håvard Midgard, Svetlana Skurtveit Bristol: Aaron G. Lim, Peter Vickerman

Funding Information:
Open access funding provided by University of Bergen. This work was supported by The Norwegian Research Council (BEHANDLING, contract no 269855); and the Western Norway Regional Health Authority («Åpen prosjektstøtte») with Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway as responsible institution. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors were funded by their respective affiliations.

Publisher Copyright:
© 2023, The Author(s).


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