Real-life data of hepatitis C treatment with direct acting antiviral therapy in persons injecting drugs or on opioid substitution therapy.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2024-11-11 DOI:10.1007/s15010-024-02433-4

Pfaeffle M, Duenkelmann S, Boesecke C, Rockstroh J K, Schwarze-Zander C

{"title":"Real-life data of hepatitis C treatment with direct acting antiviral therapy in persons injecting drugs or on opioid substitution therapy.","authors":"Pfaeffle M, Duenkelmann S, Boesecke C, Rockstroh J K, Schwarze-Zander C","doi":"10.1007/s15010-024-02433-4","DOIUrl":null,"url":null,"abstract":"Purpose: HCV treatment has been revolutionized by introduction of direct-acting antiviral therapy (DAA). Short treatment duration of eight to twelve weeks combined with significantly improved tolerability opened the opportunity to reach out to difficult-to-treat populations. Here, we retrospectively analyzed real life data on HCV treatment adherence and outcome in people who inject drugs (PWID) or on opioid substitution therapy (OST).Methods: All PWID or on OST receiving DAA therapy between 3/2021-11/2022 at an infectious disease clinic in Bonn were retrospectively analyzed. Patients received either 8 weeks glecaprevir/pibrentasvir or 12 weeks sofosbuvir/velpatasvir (+ ribavirin in genotype 3 cirrhotic patients). Sustained virological response (SVR) was measured 4 and 12 weeks after HCV therapy.Results: In our cohort 47 patients (68%) received treatment with glecaprevir/pibrentasvir and 22 patients (32%) sofosbuvir/velpatasvir. All 47 (100%) patients started on glecaprevir/pibrentasvir received prescriptions for the full length of therapy, while patients on sofosbuvir/velpatasvir completed 12 weeks therapy in 86% and 8 weeks in 14% (p = 0.029). Of 69 patients 74% were found to achieve SVR. In 20% no information is available as they were lost to follow-up. Re-infection was documented in 3 patients and one relapse in a gt3 patient with cirrhosis.Conclusion: High adherence and response rates to HCV treatment were found following DAA based therapy in PWID supporting the call to include difficult-to-treat populations into HCV treatment efforts on the way to HCV elimination. Treatment of OST and HCV at one institution supporting patients by a multidisciplinary team may further facilitate adherence to follow up visits enabling documentation of treatment outcomes more easily.","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s15010-024-02433-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: HCV treatment has been revolutionized by introduction of direct-acting antiviral therapy (DAA). Short treatment duration of eight to twelve weeks combined with significantly improved tolerability opened the opportunity to reach out to difficult-to-treat populations. Here, we retrospectively analyzed real life data on HCV treatment adherence and outcome in people who inject drugs (PWID) or on opioid substitution therapy (OST).

Methods: All PWID or on OST receiving DAA therapy between 3/2021-11/2022 at an infectious disease clinic in Bonn were retrospectively analyzed. Patients received either 8 weeks glecaprevir/pibrentasvir or 12 weeks sofosbuvir/velpatasvir (+ ribavirin in genotype 3 cirrhotic patients). Sustained virological response (SVR) was measured 4 and 12 weeks after HCV therapy.

Results: In our cohort 47 patients (68%) received treatment with glecaprevir/pibrentasvir and 22 patients (32%) sofosbuvir/velpatasvir. All 47 (100%) patients started on glecaprevir/pibrentasvir received prescriptions for the full length of therapy, while patients on sofosbuvir/velpatasvir completed 12 weeks therapy in 86% and 8 weeks in 14% (p = 0.029). Of 69 patients 74% were found to achieve SVR. In 20% no information is available as they were lost to follow-up. Re-infection was documented in 3 patients and one relapse in a gt3 patient with cirrhosis.

Conclusion: High adherence and response rates to HCV treatment were found following DAA based therapy in PWID supporting the call to include difficult-to-treat populations into HCV treatment efforts on the way to HCV elimination. Treatment of OST and HCV at one institution supporting patients by a multidisciplinary team may further facilitate adherence to follow up visits enabling documentation of treatment outcomes more easily.

查看原文本刊更多论文

注射吸毒者或接受阿片类药物替代疗法者使用直接作用抗病毒疗法治疗丙型肝炎的真实数据。

目的：直接作用抗病毒疗法（DAA）的引入彻底改变了丙型肝炎病毒（HCV）的治疗。八到十二周的短疗程加上明显改善的耐受性，使我们有机会接触到难以治疗的人群。在此，我们回顾性地分析了注射吸毒者（PWID）或接受阿片类药物替代疗法（OST）者坚持HCV治疗和治疗结果的真实数据：方法：对波恩一家传染病诊所 2021 年 3 月至 2022 年 11 月期间接受 DAA 治疗的所有注射吸毒者或阿片类替代疗法患者进行回顾性分析。患者接受了为期 8 周的 glecaprevir/pibrentasvir 或为期 12 周的 sofosbuvir/velpatasvir（基因 3 型肝硬化患者 + 利巴韦林）治疗。在接受 HCV 治疗 4 周和 12 周后测量持续病毒学应答（SVR）：在我们的队列中，47 名患者（68%）接受了 glecaprevir/pibrentasvir 治疗，22 名患者（32%）接受了 sofosbuvir/velpatasvir 治疗。所有 47 名（100%）开始接受 glecaprevir/pibrentasvir 治疗的患者都获得了完整疗程的处方，而接受 sofosbuvir/velpatasvir 治疗的患者中有 86% 完成了 12 周的治疗，14% 完成了 8 周的治疗（p = 0.029）。在 69 名患者中，74% 实现了 SVR。20%的患者因失去随访而无法获得相关信息。有记录显示，3 名患者再次感染，一名患有肝硬化的 gt3 患者复发：结论：在对吸毒者进行基于 DAA 的治疗后，发现他们对 HCV 治疗的依从性和应答率都很高，这支持了在消除 HCV 的道路上将难以治疗的人群纳入 HCV 治疗工作的呼吁。由一个多学科团队在一个机构为患者提供 OST 和 HCV 治疗，可进一步促进患者坚持随访，从而更容易记录治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.