In the Journals

Findings support expanding HCV treatment in injection drug users

Findings from two phase 4 clinical trials demonstrated that participants’ injection drug use and risk behaviors decreased or remained stable during and following treatment for hepatitis C virus infection, which researchers said supports expanding HCV treatment to everyone, regardless of injection drug use.

“In many settings, recent or prior injection drug use remain barriers to accessing direct-acting antiviral treatment (DAA) for hepatitis C virus (HCV) infection,” Andreea A. Artenie, MSc, a PhD candidate in the school of public health at the University of Montreal, and colleagues wrote. “We examined longitudinal patterns of drug and alcohol use and injection equipment sharing among people with recent injecting drug use or receiving opioid agonist treatment (OAT) during and following DAA-based treatment.”

For their study, Artenie and colleagues used data from SIMPLIFY and D3FEAT, two phase 4 clinical trials evaluating the efficacy of DAAs in people reporting injection drug use in the past 6 months or who were receiving OAT through a network of 25 international sites. According to the study, participants were recruited in 2016 and 2017 and received once-daily sofosbuvir/velpatasvir in the SIMPLIFY group or twice-daily paritepravir/ritonavir/dasabuvir/ombitasvir with or without ribavirin in the D3FEAT group for 12 weeks. Participants also completed a behavioral questionnaire before, during and after treatment for up to 2 years.

Results of the study showed that at screening, 62% of the 190 participants reported injecting drugs in the past month — including 47% who reported injecting opioids and 39% who reported injecting stimulants — 16% reported sharing injection equipment during the past month and 61% were receiving OAT. According to the study, during follow up, opioid injecting (OR = 0.95; 95% CI, 0.92-0.99) and sharing of injection equipment (OR = 0.87; 95% CI, 0.80-0.94) both decreased, though there were no significant changes observed for stimulant injecting or alcohol use, the researchers reported.

Artenie and colleagues said no increasing patterns were noted for any behaviors.

“These findings further support expanding HCV treatment to all infected [people who inject drugs], irrespective of ongoing injection drug use. More broadly, our study suggests that even in the era of simplified DAA therapies, there are ways to enhance the delivery of treatment to afford opportunities for harm reduction,” the authors concluded.

“While the majority of people undergoing HCV DAA treatment will achieve cure, reductions in sharing behaviors and risk of HCV reinfection post-treatment will likely not be achieved unless treatment services include HCV counseling and are integrated with addiction treatment and harm-reduction services.” – by Caitlyn Stulpin

Disclosures: Artenie reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Findings from two phase 4 clinical trials demonstrated that participants’ injection drug use and risk behaviors decreased or remained stable during and following treatment for hepatitis C virus infection, which researchers said supports expanding HCV treatment to everyone, regardless of injection drug use.

“In many settings, recent or prior injection drug use remain barriers to accessing direct-acting antiviral treatment (DAA) for hepatitis C virus (HCV) infection,” Andreea A. Artenie, MSc, a PhD candidate in the school of public health at the University of Montreal, and colleagues wrote. “We examined longitudinal patterns of drug and alcohol use and injection equipment sharing among people with recent injecting drug use or receiving opioid agonist treatment (OAT) during and following DAA-based treatment.”

For their study, Artenie and colleagues used data from SIMPLIFY and D3FEAT, two phase 4 clinical trials evaluating the efficacy of DAAs in people reporting injection drug use in the past 6 months or who were receiving OAT through a network of 25 international sites. According to the study, participants were recruited in 2016 and 2017 and received once-daily sofosbuvir/velpatasvir in the SIMPLIFY group or twice-daily paritepravir/ritonavir/dasabuvir/ombitasvir with or without ribavirin in the D3FEAT group for 12 weeks. Participants also completed a behavioral questionnaire before, during and after treatment for up to 2 years.

Results of the study showed that at screening, 62% of the 190 participants reported injecting drugs in the past month — including 47% who reported injecting opioids and 39% who reported injecting stimulants — 16% reported sharing injection equipment during the past month and 61% were receiving OAT. According to the study, during follow up, opioid injecting (OR = 0.95; 95% CI, 0.92-0.99) and sharing of injection equipment (OR = 0.87; 95% CI, 0.80-0.94) both decreased, though there were no significant changes observed for stimulant injecting or alcohol use, the researchers reported.

Artenie and colleagues said no increasing patterns were noted for any behaviors.

“These findings further support expanding HCV treatment to all infected [people who inject drugs], irrespective of ongoing injection drug use. More broadly, our study suggests that even in the era of simplified DAA therapies, there are ways to enhance the delivery of treatment to afford opportunities for harm reduction,” the authors concluded.

“While the majority of people undergoing HCV DAA treatment will achieve cure, reductions in sharing behaviors and risk of HCV reinfection post-treatment will likely not be achieved unless treatment services include HCV counseling and are integrated with addiction treatment and harm-reduction services.” – by Caitlyn Stulpin

Disclosures: Artenie reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.