The relative effect of hepatitis C status on mortality, if present, is likely quite small in comparison to the effect of material use disorder within the population studied. Authors contributions AA is responsible for the majority Cefepime Dihydrochloride Monohydrate of the writing and the creation of the furniture and figures. the criteria for alcohol or opioid dependence at the time of admission in 1991. The primary study end result was 20-12 months mortality after initial admission in 1991, with a planned analysis of hepatitis C status. Results Twenty years after admission, 362 patients survived and 82 had died. Of the 284 patients who were hepatitis C positive, 228 survived (80?%). Of the 160 patients who were hepatitis C negative, 134 survived (84?%). This absolute risk increase of 4?% was not statistically significant (p?=?0.37). Factors associated with increased mortality included Cefepime Dihydrochloride Monohydrate male sex, white race, older age, and reported use of alcohol, cocaine, and illicit methadone. Binary logistic regression including hepatitis C status and these other variables yielded an adjusted odds ratio of 0.87 (95?% CI 0.49C1.55); (p?=?0.64) for hepatitis C positive 20-year survival. Conclusions Hepatitis C positivity was not associated with a statistically significant difference in 20-year survival. The effect of the virus on mortality, if present, is small, relative to the effect of substance use disorders alone. value*gaining increased popularity . Given a system with limited financial resources, it may be reasonable to question which therapies would provide the greatest health benefit to patients with substance use disorders. The average cost per treatment episode for outpatient substance use disorder is $2000C7000 . The cost of new oral treatment for hepatitis C infection has been estimated at $84,000 per 12-week course of therapy . Our study suggests that substance use disorders alone increase mortality, a finding that is consistent with prior Rabbit polyclonal to ACMSD research [46C48]. It does not, however, support the idea that hepatitis C virus was responsible for a significant fraction of that mortality. Although in a perfect system all patients would be treated for both, Cefepime Dihydrochloride Monohydrate our study suggests that younger patients with substance use disorders may derive more mortality benefit from addiction treatment than they would derive from treatment of hepatitis C virus. This effect may shift over time as patients get older. Further research is necessary to establish which patients would be best served by treatment for one or both conditions. Conclusions Hepatitis C antibody positivity was not associated with a statistically significant change in 20?years mortality among a cohort of patients with substance use disorders within an urban setting. The overall mortality of the cohort was higher than that of the general population in both hepatitis C positive and hepatitis C negative patients. The relative effect of hepatitis C status on mortality, if present, is likely quite small in comparison to the effect of substance use disorder within the population studied. Authors contributions AA is responsible for the majority of the writing and the creation of the tables and figures. MF was the author of the original study, the source of the patient data, and the originator Cefepime Dihydrochloride Monohydrate of the study concept. DR gave specific feedback and oversight for data analysis in regard to the regression analysis and the adjusted odds ratios?and aided greatly with revisions and edits. SG performed the initial statistical analysis. All authors read and approved the final manuscript. Acknowledgements All of the authors had full access to all of the data in the study. Anthony Accurso takes responsibility for the integrity of the data and the accuracy of the data analysis. Competing interests The authors declare that they have no competing interests. Financial disclosures None of the authors have any financial disclosures or conflicts of interest. Contributor Information Anthony J. Accurso, Phone: 410-929-2681, Email: moc.liamg@osruccatna. Darius A. Rastegar, Email:.