People with hepatitis C virus infection and a recent or current history of drug use who were enrolled in a multidisciplinary care program responded well to direct-acting antiviral therapy and achieved a high rate of SVR, according to data presented at the International Symposium on Hepatitis Care in Substance Users.
The findings support the feasibility of prioritizing people who use drugs (PWUD) to receive treatment for HCV, according to Arshia Alimohammadi, clinical researcher at Vancouver Infectious Diseases Centre, and colleagues.
“The number of people around the world dying from hepatitis C is increasing,” Jason Grebely, MSc, PhD, associate professor at the Kirby Institute, University of New South Wales in Australia, and president of the International Network of Hepatitis C in Substance Users, said in a press release. “We have the tools to reverse this trend, to eliminate this disease and save millions of lives. But it will not happen until people who use drugs become a focus of our efforts.”
Alimohammadi and colleagues performed a retrospective analysis on PWUD with HCV receiving multidisciplinary care that addressed medical, psychologic, social and addiction-related needs at the Vancouver Infectious Diseases Centre. The primary outcome was achievement of SVR.
The analysis included 185 patients who had initiated direct-acting antiviral (DAA) therapy since March 2014. Among them, 87 received Sovaldi (sofosbuvir, Gilead Sciences) and 49 received Viekira Pak (paritaprevir/ritonavir, ombitasvir and dasabuvir, AbbVie). Sixty-six patients were also assigned to ribavirin.
To date, 145 patients achieved SVR. Six cases of virologic failure occurred after treatment, yielding an overall SVR rate of 95.8%. The researchers did not find evidence of specific treatment regimens having an effect on SVR. They concluded that within a multidisciplinary care model, DAA treatment is well-tolerated and highly effective among PWUD.
"The new data support comprehensive policies to make PWUD a priority population for HCV therapy regardless of disease stage," Brian Conway, MD, FRCPC, president and medical director of Vancouver Infectious Diseases Centre, told Infectious Disease News. "All clinicians providing care to PWUD should develop strategies to test for HCV and design a plan for rapid access to curative treatment in this particularly vulnerable population." – by Stephanie Viguers
Alimohammadi A, et al. All-Oral Anti-HCV Therapy in Injection Drug Users: Updated Real World Data. Presented at: The 6th International Symposium on Hepatitis Care in Substance Users; Sept. 6-8, 2017; Jersey City, New Jersey.
Disclosure: One author reports receiving grants from AbbVie, Gilead Sciences, Janssen Pharmaceuticals, Merck and ViiV Healthcare.