Collocation of Buprenorphine with HCV treatment to improve adherence and reduce harm in PWID with HCV: Preliminary data from the ANCHOR study

Rosenthal, Elana; Hill, Kareen; Nussdorf, Laura; Mathur, Poonam; Gross, Chloe; Silk, Rachel; Akoth, E.; Sternberg, David; Sidique, Nadeera; Chaudhury, C.; Babalola, Emmanuel; Masur, Henry; Kottilil, Shyam; Kattakuzhy, Sarah

doi:10.1016/s0168-8278(18)30322-2

Cited by 7 publications

(2 citation statements)

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“…Of note, at variance with studies using electronic blisters to ensure adherence of PWID patients, in our study, patients underwent a monthly visit associated with returning empty bottles and refilling. Similar SVR12 rates were shown more recently in HIV/HCV co-infected patients in Germany [25–27]. Strictly related to the PWID treatment is the issue of re-infection.…”

Section: Discussionsupporting

confidence: 80%

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

et al. 2019

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Background and objectives The pangenotypic single tablet regimen of NS5B inhibitor sofobuvir (SOF) and NS5A inhibitor velpatasvir (VEL) is advised for 12 weeks in HCV-infected patients including those with compensated cirrhosis. Addition of ribavirin (RBV) may be considered in genotype 3 (GT3) with compensated and is recommended in decompensated cirrhosis. Real-life results with SOF/VEL are limited. To evaluate efficacy and safety in a large real-world-cohort including patients with different GTs and various fibrosis stages. Design In total, 1429 patients were treated with SOF/VEL 400/100 mg for 12 weeks in the Puglia registry between June 2017 and May 2018. 1319 (92.3%) reached week 12 post-treatment (SVR12) at the moment. Only 41 received RBV. Diagnosis of cirrhosis was based on transient elastography and/or APRI or FIB-4 scores. Sensitivity analysis in the population including all patients except non virological failure was conducted. Primary efficacy endpoint was the percentage of patients with SVR12. Results Patients’ mean age was 63.8 years, 42.3% had GT1. The majority were naïve and 735 (55.5%) F0/F2. Of the remaining 587, 282 had cirrhosis. SVR12 was 98.5%, 98.0% in GT1, 99.4% in GT2, 97.1% in GT3, 100% in GT4. Overall, SVR12 by sensitivity analysis was 99.4%; 99.7% among F0-F1. Among 218 PWID, SVR12 was 94.5%. Discontinuation rates were 3.7% among PWID and 0.7% among non-PWID (p = 0.004). Conclusions SOF/VEL treatment of chronic HCV infection reaches very high cure rates in a variety of patients; including those with F0/F1 and PWID.

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Section: Discussionsupporting

confidence: 80%

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

et al. 2019

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“…Of the 90 patients treated, 30% were on OST at baseline and 43% initiated OST during HCV treatment and 24% did not. Those on OST were more adherent to HCV visits and reported lower high-risk behaviors 56 . Other models of care include directly observed HCV therapy and peer-based models 57 .…”

Section: Under-treatment: More Than Just the Costmentioning

confidence: 98%

Hepatitis C elimination: challenges with under-diagnosis and under-treatment

Terrault

2019

F1000Res

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Hepatitis C infection has affected 189 million people globally and more than 4 million in the US. Owing to remarkable advances in the therapeutic sphere, essentially all infected patients can be expected to achieve cure. This provides an unprecedented opportunity to eliminate the risk of complications from hepatitis C and to reduce the spread of the virus to others. To achieve this, a streamlined cascade of care from diagnosis to treatment may be enacted. Although great strides have been made, under-diagnosis and under-treatment remain major hurdles.

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