Didier Laureillard, Nguyen Thanh Binh, Vu Hai Vinh, Tran Thi Hong, Catherine Quillet, Nham Thi Tuyet Thanh, Roselyne Vallo, Bach Thi Nhu Quynh, Jean Pierre Moles, Khuat Thi Hai Oanh, Duong Thi Huong, Delphine Rapoud, Jonathan Feelemyer, Laurent Michel, Peter Vickerman, Hannah Fraser, Laurence Weiss, Maud Lemoine, Karine Lacombe, Don Des Jarlais, Pham Minh Khue, Nicolas Nagot
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引用次数: 0
Abstract
People who inject drugs (PWID) are highly affected by hepatitis C (HCV) worldwide, particularly in low- and middle-income countries (LMICs), where access to addiction services is often limited. Reducing the burden of HCV, as promoted by WHO, requires effective interventions in this high-risk population. Here, we report the safety and efficacy of a pangenotypic generic HCV treatment among PWID in Vietnam, using a sofosbuvir/daclatasvir regimen. PWID were screened for HCV at two community-based organisations (CBO) premises in Haiphong during both a respondent-driven sampling survey and cohort follow-up visits. PWID with detectable HCV RNA were referred to three public hospitals for a 12-week regimen of generic sofosbuvir/daclatasvir, with ribavirin if cirrhosis, and with CBO support for referral and adherence. Treatment safety was assessed over the course of treatment and success was measured by sustained virologic response 12 weeks after the end of treatment (SVR12). Of the 1201 PWID screened with detectable HCV RNA, 1021 were enrolled: 96% male, median age 42 years, 45% HIV-infected, 16% with advanced liver fibrosis, 55% currently injecting, and 71.5% on methadone maintenance therapy (MMT). In total, 979 participants started HCV treatment, and 901 of the 924 participants tested at SVR12 (98%) were cured. Genotype 3, current drug use, lack of MMT, and HIV infection were independently associated with treatment failure. High HCV cure rates can be achieved among PWID in LMICs such as Vietnam using a simple model of care, including a pangenotypic generic direct-acting antiviral combination and CBO support.
期刊介绍:
The Journal of Viral Hepatitis publishes reviews, original work (full papers) and short, rapid communications in the area of viral hepatitis. It solicits these articles from epidemiologists, clinicians, pathologists, virologists and specialists in transfusion medicine working in the field, thereby bringing together in a single journal the important issues in this expanding speciality.
The Journal of Viral Hepatitis is a monthly journal, publishing reviews, original work (full papers) and short rapid communications in the area of viral hepatitis. It brings together in a single journal important issues in this rapidly expanding speciality including articles from:
virologists;
epidemiologists;
clinicians;
pathologists;
specialists in transfusion medicine.