Background. Methamphetamine and opioid use disorders (MUD/OUD) are increasing in the US, paralleled by a surge in hepatitis C virus (HCV). HCV is curable with direct-acting antiviral medication (DAA), but people with HCV who use drugs often don’t receive it. We estimated differences in DAA by substance type among people with HCV in Arkansas. Methods. We used a statewide medical claims database to identify HCV cases who also had MUD, OUD, and/or AUD (pooled 2018–2022; N = 5439). We used multiple logistic regression to model DAA receipt, adjusted for relevant covariates. Results. Only 10% of our sample received DAA. The lowest predicted probabilities of DAA receipt were among people who used methamphetamine (4.5%) and those covered by Medicaid (5.4%). Conclusion. Arkansas Medicaid has the strictest requirements for initiating DAA in the country. Public health efforts that reduce exposure to HCV among people who use drugs will reduce the HCV burden in Arkansas.

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2018-2022 年阿肯色州甲基苯丙胺、阿片类药物和酒精使用障碍患者的 HCV 药物使用情况：美国南部消除 HCV 的道路还很长

背景。在美国，甲基苯丙胺和阿片类药物使用障碍 (MUD/OUD) 正在增加，与此同时，丙型肝炎病毒 (HCV) 也在激增。HCV 可以通过直接抗病毒药物 (DAA) 治愈，但使用药物的 HCV 患者通常不会接受治疗。我们估计了阿肯色州 HCV 患者中不同物质类型的 DAA 差异。方法。我们使用全州医疗索赔数据库来识别同时患有 MUD、OUD 和/或 AUD 的 HCV 病例（2018-2022 年汇总；N = 5439）。我们使用多元逻辑回归对 DAA 收据进行建模，并针对相关协变量进行调整。结果。我们的样本中只有 10% 接受了 DAA。接受 DAA 的预测概率最低的是使用甲基苯丙胺的人群 (4.5%) 和医疗补助覆盖的人群 (5.4%)。结论。阿肯色州医疗补助计划对启动 DAA 的要求是全国最严格的。减少吸毒者接触丙肝病毒的公共卫生努力将减少阿肯色州的丙肝病毒负担。