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Direct-acting antiviral treatment for chronic hepatitis C in people who use drugs in a real-world setting. | LitMetric

Direct-acting antiviral treatment for chronic hepatitis C in people who use drugs in a real-world setting.

Ann Gastroenterol

Gastroenterology-Liver Unit, 2 Academic Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, Hippokration General Hospital, (Kanellos Rafail Koustenis, Olga Anagnostou, Hariklia Kranidioti, Sofia Vasileiadi, Pinelopi Antonakaki, Evangelia Koutli, Paris Pantsas, Melanie Deutsch, Spilios Manolakopoulos).

Published: January 2020

AI Article Synopsis

  • Direct-acting antivirals (DAAs) show high cure rates for hepatitis C in people who inject drugs (PWID), but real-world response rates vary, prompting a study on outcomes and influencing factors among PWID in Greece.
  • A retrospective analysis of 174 PWID revealed an overall sustained virological response (SVR12) rate of 79.9%, with a higher rate of 96.5% among those who completed therapy and attended follow-up.
  • Key findings highlighted that younger patients (under 45) and those with genotype 3 were more likely to be lost to follow-up, indicating the need for better support systems for patient retention post-treatment.

Article Abstract

Background: Direct-acting antivirals (DAAs) offer high cure rates in people who inject drugs (PWID) with hepatitis C virus (HCV) infection. There are concerns regarding lower response rates among PWID in real life. We evaluated the outcome of DAA therapy in PWID in a real-world setting and the factors that affect it.

Methods: We performed a retrospective analysis of 174 PWID with chronic hepatitis C who started DAAs in a Greek liver clinic in collaboration with an addiction program. Patients who did not return for reassessment were considered as lost to follow up (LTFU). A logistic regression model was used to assess factors associated with a sustained virological response 12 weeks after treatment completion (SVR12) and LTFU.

Results: Patients' mean age was 48±9.2 years and 91/174 (52.3%) were attending opioid substitution treatment programs. Overall, 144/174 (82.8%) patients completed therapy and presented for SVR12 testing, 8/174 (4.6%) did not complete treatment and 22/174 (12.6%) were LTFU. Overall SVR12 was 79.9% (139/174). For those with an available SVR12 test the response rate reached 96.5% (139/144). Regression analysis did not indicate any significant association between patient characteristics and SVR12. Age <45 years and genotype 3 were independent predictors of LTFU. Parallel use was found to have a trend towards LTFU.

Conclusions: HCV treatment by hepatologists and addiction specialists is feasible, effective and safe in a real-world setting. However, as 12% of patients appear to be LTFU, more emphasis should be placed on interventions guaranteeing follow up for SVR testing and general care.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049240PMC
http://dx.doi.org/10.20524/aog.2020.0449DOI Listing

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