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Challenges in hepatitis C elimination despite highly effective antiviral agents in patients with and without

Simona Bota1, Marcel Razpotnik1, Florian Hucke1

  • 1Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE), Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria.

Wiener Klinische Wochenschrift
|May 25, 2021
PubMed

Insights

Hepatitis C treatment adherence and sustained virologic response (SVR) rates were lower in people who inject drugs (PWID) compared to non-PWID. Enhanced treatment strategies are crucial for hepatitis C elimination in PWID.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C Virus (HCV) infection remains a significant global health concern.
  • Intravenous drug use is a major risk factor for HCV infection and can impact treatment outcomes.
  • Understanding treatment adherence and response in different patient populations is vital for HCV elimination efforts.

Purpose of the Study:

  • To compare treatment adherence and sustained virologic response (SVR) rates in hepatitis C patients with and without a history of intravenous drug use.
  • To investigate factors influencing treatment compliance and SVR in people who inject drugs (PWID).
  • To assess the reinfection rate in hepatitis C patients, differentiating between PWID and non-PWID.

Main Methods:

  • Retrospective study of 431 hepatitis C patients treated between January 2014 and October 2019.
  • Data collected included HCV viral load, history of i.v. drug use, HCV genotype, treatment regimen, SVR, reinfection rates, HIV coinfection, and ongoing opioid substitution therapy (OST).
  • Comparison of outcomes between people who inject drugs (PWID) and non-PWID cohorts.

Main Results:

  • Sustained virologic response (SVR) rates were significantly higher in non-PWID (91.5%) compared to PWID (61.5%).
  • Treatment noncompliance was significantly higher in PWID (19.4%) versus non-PWID (8.9%).
  • Younger age, recent i.v. drug use, and ongoing opioid substitution therapy (OST) were associated with compliance in PWID.

Conclusions:

  • Current treatment strategies show disparities in outcomes between PWID and non-PWID.
  • Achieving hepatitis C elimination requires tailored treatment strategies for people who inject drugs (PWID).
  • Further research and targeted interventions are needed to improve hepatitis C treatment adherence and SVR rates in PWID.
Abstract

Keywords:
Adherence to treatmentHepatitis C virusHepatitis eradicationOpioid substitution therapy, OSTPeople who inject drugs, PWID

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