People who inject drugs (PWID) can have an excellent response to sofosbuvir-based therapy for hepatitis C virus (HCV) infection, Ukrainian research presented to the recent 2016 AASLD Liver Meeting shows.
Overall, 93% of people had a sustained virological response 12 weeks (SVR12) after the completion of therapy. Most people had co-infection with HIV. Individuals received peer support and support from non-governmental organisations (NGOs).
Since June 2016, the Ukrainian Alliance for Public Health has been providing sofosbuvir-based HCV therapy to at-risk populations. As of October 2016, 1192 people have been provided with therapy, with 80% of treated people being PWIDs.
Investigators reported on the treatment outcomes of 456 people who started therapy between July 2015 and April 2016. Outcomes were stratified according to HCV genotype.
The majority of individuals (89%) had co-infection with HIV, and almost all these individuals (97%) were taking antiretroviral therapy. A minority of people (14%) had previous experience of interferon-based HCV treatment and 8% were receiving opioid substitution therapy. A fifth had a history of tuberculosis. The median age was 39 years and 81% of people were male. As regards fibrosis stage, 11% of individuals were F1, 39% F2, 26% F3 and 24% F4. Approximately half (n = 231) carried HCV genotype 1, 34 had genotype 2 infection, 185 had genotype 3 and six individuals had genotype 4.
Care was provided by a multidisciplinary team, involving healthcare professionals, social workers and NGOs.
Most people (n = 379) received therapy consisting of sofosbuvir in combination with pegylated interferon and ribavirin, with treatment lasting 12 weeks.
The overall SVR12 rate was 93%, with 94% of people treated with sofosbuvir, pegylated interferon and ribavirin attaining this outcome.
All six people with genotype 4 attained a SVR12, as did 97% of individuals with genotype 3, 91% of people with genotype 1 and 82% of people with genotype 4.
“Sofosbuvir-based HCV treatment in PWID population shows high cure rates in all fibrosis stages and genotypes,” conclude the investigators. “Re-infection interventions should be included as one of the obligatory activities for active PWID.”
Filippovych SA et al. Real-setting treatment data in people who inject drugs treated with sofosbuvir-based regimens in the Ukraine. The 67th Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting, poster presentation, Boston, 2016.