BACKGROUND: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infected people who inject drugs (PWID) treated with direct acting antivirals (DAAs). METHODS: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated with DAAs. The primary outcome evaluated was the sustained virological response (SVR12) rate. RESULTS: Five hundred and twenty HCV-infected PWID treated with all-oral DAA-based regimens were enrolled; a total of 168 (32.3%) patients presented genotype 1a, 109 (21.0%) genotype 1b, and 174 (33.5%) genotype 3; a total 152 of the 520 subjects (29.2%) were cirrhotics; a total 118 (22.7%) and 373 (71.7%) were treated with DAA regimens of second and third generation, respectively; a total 169 (33.6%) patients were receiving an opioid agonist at the start of antiviral therapy. Only 11 subjects (2.1%) did not show an SVR12. A significant correlation was found between treatment with opioid substitution therapy (p < 0.001), Human Immunodeficiency Virus (HIV) coinfection (p = 0.002), and treatment with first- or second-generation regimens (p = 0.0015) and HCV failure. Upon multivariate analysis, treatment with a first- or second-generation DAA was the only factor independently associated with failure (OR 10.4, 95% CI: 1.43 to 76.1, p = 0.02). CONCLUSIONS: Treatment with DAAs led to a high SVR12 rate (97.9%) in a large cohort of HCV-infected PWID. The only predictor of viral failure found in our analysis was treatment with first- and second-generation DAA.
BACKGROUND: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infectedpeople who inject drugs (PWID) treated with direct acting antivirals (DAAs). METHODS: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated with DAAs. The primary outcome evaluated was the sustained virological response (SVR12) rate. RESULTS: Five hundred and twenty HCV-infected PWID treated with all-oral DAA-based regimens were enrolled; a total of 168 (32.3%) patients presented genotype 1a, 109 (21.0%) genotype 1b, and 174 (33.5%) genotype 3; a total 152 of the 520 subjects (29.2%) were cirrhotics; a total 118 (22.7%) and 373 (71.7%) were treated with DAA regimens of second and third generation, respectively; a total 169 (33.6%) patients were receiving an opioid agonist at the start of antiviral therapy. Only 11 subjects (2.1%) did not show an SVR12. A significant correlation was found between treatment with opioid substitution therapy (p < 0.001), HumanImmunodeficiency Virus (HIV) coinfection (p = 0.002), and treatment with first- or second-generation regimens (p = 0.0015) and HCV failure. Upon multivariate analysis, treatment with a first- or second-generation DAA was the only factor independently associated with failure (OR 10.4, 95% CI: 1.43 to 76.1, p = 0.02). CONCLUSIONS: Treatment with DAAs led to a high SVR12 rate (97.9%) in a large cohort of HCV-infected PWID. The only predictor of viral failure found in our analysis was treatment with first- and second-generation DAA.
Authors: Jason Grebely; Olav Dalgard; Brian Conway; Evan B Cunningham; Philip Bruggmann; Behzad Hajarizadeh; Janaki Amin; Julie Bruneau; Margaret Hellard; Alain H Litwin; Philippa Marks; Sophie Quiene; Sharmila Siriragavan; Tanya L Applegate; Tracy Swan; Jude Byrne; Melanie Lacalamita; Adrian Dunlop; Gail V Matthews; Jeff Powis; David Shaw; Maria Christine Thurnheer; Martin Weltman; Ian Kronborg; Curtis Cooper; Jordan J Feld; Chris Fraser; John F Dillon; Phillip Read; Ed Gane; Gregory J Dore Journal: Lancet Gastroenterol Hepatol Date: 2018-01-06
Authors: Jason Grebely; Massimo Puoti; Heiner Wedemeyer; Curtis Cooper; Mark S Sulkowski; Graham R Foster; Thomas Berg; Erica Villa; Federico Rodriguez-Perez; David L Wyles; Gretja Schnell; Negar N Alami; Zhenzhen Zhang; Emily Dumas; Gregory J Dore Journal: Open Forum Infect Dis Date: 2018-09-27 Impact factor: 3.835