Hepatitis C Treatments Ok for Injection Drug Users

SAN FRANCISCO:
Most people who inject illicit drugs can complete treatment for hepatitis C and achieve a cure using direct-acting antiviral (DAA) therapy, even if they do not have perfect adherence, according to study results presented here.

People who eventually finished at least 8 weeks of an intended 12-week course of sofosbuvir/velpatasvir (Epclusa) had a high likelihood of achieving sustained virological response (SVR), even if they had gaps in treatment.

“Our data demonstrate that people who inject drugs can achieve SVR at comparable rates to non-drug using populations, even if adherence is imperfect,” said Elana Rosenthal, MD, of the Institute of Human Virology at the University of Maryland in Baltimore. “With access to hepatitis C treatment and culturally competent care, hepatitis C elimination in people who inject drugs is an achievable target.”

Rosenthal presented results from the ANCHOR study, which evaluated hepatitis C treatment at a harm reduction drop-in center in Washington, D.C., at the annual Liver Meeting, sponsored by the American Association for the Study of Liver Diseases (AASLD).

Hepatitis C virus (HCV) is readily transmitted via shared syringes, and people who inject drugs have a high prevalence of HCV infection worldwide. Widespread treatment of people who inject drugs is key to the elimination of hepatitis C, but this population has often been denied access to highly effective DAAs due to concerns about poor adherence or reinfection after being cured.

But these fears appear to be unfounded. A recent meta-analysis by Jason Grebely, PhD, of the Kirby Institute at the University of New South Wales, and colleagues found that across eight studies of people who report recent injection drug use, 97% completed DAA treatment and 87% achieved SVR. Less is known, however, about outcomes in real-world settings.