Nathalie Scherz1, Philip Bruggmann2, Nathalie Brunner3. 1. Arud Center for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland; Institute of Primary Care, University and University Hospital of Zurich, Switzerland. Electronic address: n.scherz@usz.ch. 2. Arud Center for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland. Electronic address: p.bruggmann@arud.ch. 3. Arud Center for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland. Electronic address: n.brunner@arud.ch.
Abstract
BACKGROUND: Treating chronic hepatitis C virus (HCV) infection among PWID (people who inject drugs) is crucial to achieve the WHO goal of HCV elimination, as this population is highly affected and carries a high risk of transmission. The aim of our study was to provide real-life data on HCV treatment among PWID either in opioid agonist treatment (OAT) or in heroin-assisted treatment (HAT) in a low-threshold access primary care-based addiction medicine institution. METHODS: We conducted a retrospective chart analysis of patients treated with direct-acting antivirals (DAA) between 10/2014 and 08/2017 in the Arud outpatient clinics in Zurich, Switzerland. We reported patient and treatment characteristics and substance use. The outcomes were sustained virological response (SVR) by intention-to-treat (ITT) and modified ITT (mITT) analyses, excluding patients with missing SVR data. RESULTS: We included 64 patients in our analysis. Forty-two (66%) were in OAT, and 22 (34%) were in HAT. Twenty-six patients (41%) reported harmful alcohol use, and 9 patients (14%) reported injecting drug use during DAA treatment. Every patient completed the treatment. Fifty-nine out of 64 achieved SVR resulting in an ITT SVR rate of 92.2%. Two patients had virological failure. Three patients were lost to follow-up between the end of treatment and SVR12 visit. Excluding these 3 patients, our study showed an mITT SVR rate of 96.7%. CONCLUSION: PWID can be treated with DAA treatment integrated in OAT and HAT with an excellent SVR rate. OAT and HAT programs should offer integrated HCV treatment to their patients.
BACKGROUND: Treating chronic hepatitis C virus (HCV) infection among PWID (people who inject drugs) is crucial to achieve the WHO goal of HCV elimination, as this population is highly affected and carries a high risk of transmission. The aim of our study was to provide real-life data on HCV treatment among PWID either in opioid agonist treatment (OAT) or in heroin-assisted treatment (HAT) in a low-threshold access primary care-based addiction medicine institution. METHODS: We conducted a retrospective chart analysis of patients treated with direct-acting antivirals (DAA) between 10/2014 and 08/2017 in the Arud outpatient clinics in Zurich, Switzerland. We reported patient and treatment characteristics and substance use. The outcomes were sustained virological response (SVR) by intention-to-treat (ITT) and modified ITT (mITT) analyses, excluding patients with missing SVR data. RESULTS: We included 64 patients in our analysis. Forty-two (66%) were in OAT, and 22 (34%) were in HAT. Twenty-six patients (41%) reported harmful alcohol use, and 9 patients (14%) reported injecting drug use during DAA treatment. Every patient completed the treatment. Fifty-nine out of 64 achieved SVR resulting in an ITT SVR rate of 92.2%. Two patients had virological failure. Three patients were lost to follow-up between the end of treatment and SVR12 visit. Excluding these 3 patients, our study showed an mITT SVR rate of 96.7%. CONCLUSION: PWID can be treated with DAA treatment integrated in OAT and HAT with an excellent SVR rate. OAT and HAT programs should offer integrated HCV treatment to their patients.
Authors: Lamia Y Haque; Jenna L Butner; Julia M Shi; Susan Henry; Yanhong Deng; Maria M Ciarleglio; Lynn M Madden; Jeanette M Tetrault Journal: J Addict Med Date: 2022 May-Jun 01 Impact factor: 4.647
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