BACKGROUND:People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV) infection. However, PWID are considered "difficult to treat," requiring a specifically adapted treatment setting, including psychosocial support. METHODS: In this prospective, German trial, the impact of psychoeducation (PE) on retention and sustained virologic response (SVR) during HCV therapy among PWID was evaluated. We included 198 patients in opiate substitution therapy, who fulfilled indications for antiviral treatment. All patients received pegylated interferon alfa-2a and ribavirin therapy. Patients in the intervention group (n = 82) received manualized PE sessions. RESULTS: In patients with HCV genotype 1 or 4 (GT 1/4), PE was associated with increased treatment completion (76% vs 55%, P = .038), whereas PE had no such effect among GT 2/3 patients, who showed fewer dropouts and higher SVR rates. Among GT 1/4 patients, a minimum of 5 PE sessions was associated with increased SVR (71% vs 48%, P = .037). Multivariate regression analyses confirmed the impact of PE in GT 1/4 and revealed further predictors for retention and SVR, such as preexisting mental distress and adverse events. CONCLUSIONS: In patients with a higher risk of dropout due to GT 1/4 or mental distress, PE was shown to improve retention and SVR. PE is an effective supportive intervention for HCV therapy among PWID.
RCT Entities:
BACKGROUND:People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV) infection. However, PWID are considered "difficult to treat," requiring a specifically adapted treatment setting, including psychosocial support. METHODS: In this prospective, German trial, the impact of psychoeducation (PE) on retention and sustained virologic response (SVR) during HCV therapy among PWID was evaluated. We included 198 patients in opiate substitution therapy, who fulfilled indications for antiviral treatment. All patients received pegylated interferon alfa-2a and ribavirin therapy. Patients in the intervention group (n = 82) received manualized PE sessions. RESULTS: In patients with HCV genotype 1 or 4 (GT 1/4), PE was associated with increased treatment completion (76% vs 55%, P = .038), whereas PE had no such effect among GT 2/3 patients, who showed fewer dropouts and higher SVR rates. Among GT 1/4patients, a minimum of 5 PE sessions was associated with increased SVR (71% vs 48%, P = .037). Multivariate regression analyses confirmed the impact of PE in GT 1/4 and revealed further predictors for retention and SVR, such as preexisting mental distress and adverse events. CONCLUSIONS: In patients with a higher risk of dropout due to GT 1/4 or mental distress, PE was shown to improve retention and SVR. PE is an effective supportive intervention for HCV therapy among PWID.
Entities:
Keywords:
antiviral treatment; hepatitis C; injection drug users; psychoeducation; retention
Authors: Bernd Schulte; Christiane S Schmidt; Jakob Manthey; Lisa Strada; Stefan Christensen; Konrad Cimander; Herbert Görne; Pavel Khaykin; Norbert Scherbaum; Stefan Walcher; Stefan Mauss; Ingo Schäfer; Uwe Verthein; Jürgen Rehm; Jens Reimer Journal: Open Forum Infect Dis Date: 2020-08-13 Impact factor: 3.835
Authors: Christoph Höner Zu Siederdissen; Peter Buggisch; Klaus Böker; Eckart Schott; Hartwig Klinker; Anita Pathil; Heike Pfeiffer-Vornkahl; Thomas Berg; Christoph Sarrazin; Dietrich Hüppe; Michael P Manns; Stefan Mauss Journal: United European Gastroenterol J Date: 2017-06-17 Impact factor: 4.623
Authors: Jean-Michel Delile; Victor de Ledinghen; Marie Jauffret-Roustide; Perrine Roux; Brigitte Reiller; Juliette Foucher; Daniel Dhumeaux Journal: Hepatol Med Policy Date: 2018-06-05