High dropout rate from aftercare program of antihepatitis C therapy for patients with history of injection drug use

Abstract

Background and Aim: We assessed direct-acting antiviral (DAA) treatment for patients with hepatitis C virus (HCV) and a history of injection drug use (IDU) in Japan. Method: This retrospective observational study was based on clinical records. Overall, 804 DAA-naïve HCV-infected patients were enrolled, treated with a 12-week regimen of DAAs, and had available information about a history of IDU. Anti-HCV efficacy was defined as a sustained viral response 12 weeks post-treatment (SVR12) only in patients who were assessed after 12 weeks [modified intention-to-treat (ITT) analyses]. We compared the antiviral effect between patients with (past-IDU) and without a history of IDU (non-IDU). We also evaluated the characteristics of each group, including the overall dropout rate and economic background. Results: Overall, 78 (9.7%) patients had a history of IDU. Compared to the non-IDU group at baseline, the past-IDU group consisted of predominantly male and younger patients infected with HCV genotype 2. Overall, 3% (3/78) and 16% (116/726) of the patients had cirrhosis in the past-IDU and non-IDU group, respectively. There was a significantly higher rate of welfare recipients in the past-IDU group. SVR rate was 97% (59/61) in the past-IDU group and 99% (689/699) in the non-IDU group. The cumulative rate of dropout from an aftercare program was high in the past-IDU group (P < 0.01). Conclusions: DAAs had a remarkable anti-HCV effect in patients with past-IDU who continued in an aftercare program. It is necessary to understand the characteristics of past-IDU patients to establish a support system for aftercare programs. Patients and methods Cohort. We used the clinical records of HCV-infected patients who were treated with interferon-free DAAs between September

A single site study to investigate the current prevalence of anti‐hepatitis C virus antibody among substance use disorder patients in Hiroshima—Insufficient testing and diagnosis

“…[2][3][4] By contrast, little recognition and few approaches are available to address this issue in Japan. 5 To date, general countermeasures against viral hepatitis have been highly appreciated in Japan. 6 Soon after the discovery of HCV, screening of blood for transfusion and blood products was initiated.…”

“…Moreover, there is a lack of literature on the management of HCV testing and treatment among PWUDs, and there are only a few reports on HCV treatment among PWUDs and PWIDs in Japan. 5 To achieve the WHO viral hepatitis elimination goal, it is critical to test for and treat chronic HCV in PWIDs/PWUDs, as they are a potential source of new infections. This study was, therefore, conducted to investigate the current disease status by assessing the seroprevalence of anti-HCV Ab among PWIDs and PWUDs in Japan.…”

“…Medical associations and the Centers for Disease Control and Prevention (CDC) have taken initiatives to address this problem 2–4 . By contrast, little recognition and few approaches are available to address this issue in Japan 5 …”

“…Although the major risk factors for HCV transmission are considered to be injection drug use and tattooing, 12 there is no current data in Japan on the prevalence of anti‐HCV Ab among PWUDs, and there are no data regarding how many PWUDs received confirmatory HCV RNA testing and subsequent treatment. Moreover, there is a lack of literature on the management of HCV testing and treatment among PWUDs, and there are only a few reports on HCV treatment among PWUDs and PWIDs in Japan 5 …”