Direct acting antiviral-based treatment of hepatitis C virus infection among people who inject drugs in Georgia: A prospective cohort study

被引：12

作者：

Bouscaillou, Julie ^{[1
]}

Kikvidze, Tamar ^{[2
]}

Butsashvili, Maia ^{[3
]}

Labartkava, Konstantine ^{[4
]}

Inaridze, Ina ^{[2
]}

Etienne, Aurelie ^{[1
]}

Le Pluart, Diane ^{[1
]}

Kamkamidze, George ^{[3
]}

Gamezardashvili, Ana ^{[3
]}

Kharshiladze, David ^{[2
]}

Avril, Elisabeth ^{[1
]}

Luhmann, Nildas ^{[1
]}

机构：

[1] Med Monde France, 62 Rue Marcadet, F-75018 Paris, France

[2] Med Monde Georgia, 46 Gutnis St, GE-0103 Tbilisi, Georgia

[3] Clin Neolab, 47 Tashkent St, GE-0160 Tbilisi, Georgia

[4] New Vector, 9 Mtskheta St, GE-0179 Tbilisi, Georgia

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2018年 / 62卷

关键词：

People who inject drugs; Hepatitis C virus; Adherence; SVR; Direct acting antiviral; Middle income country; THERAPY; HCV; HIV; RECOMMENDATIONS; ELIMINATION; PREVENTION; SOFOSBUVIR; EFFICACY; ACCESS; SAFETY;

D O I：

10.1016/j.drugpo.2018.07.016

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: People who inject drugs (PWID) are often excluded from HCV treatment programs due to concerns about their ability to adhere to care. Georgia has a high prevalence of HCV infection (5.4% of chronic cases in general population) with an epidemic concentrated among PWID. We evaluated adherence to care and sustained virologic response (SVR) among PWID in Georgia. Methods: In this observational study, participants with recent injecting drug use (previous 6 months) and chronic HCV attending a needle- and syringe-program were included. Participants received sofosbuvir and ribavirin + /pegylated interferon, with peer-based support during treatment. The primary endpoint was undetectable HCV RNA 12 weeks post-treatment (SVR12). Factors associated with SVR were assessed using logistic regression. Results: Among 244 participants [HCV genotype (GT) 3, 52%; GT2, 25%; GT1, 19%; mixed GT, 4%]; 55% had cirrhosis. Overall, 24% were receiving OST and 50% injected drugs in the previous month. 98% (239 of 244) completed treatment, with 88% (210 of 239) having never delayed a medical appointment and 79% (189 of 239) never missing a dose of medication. Overall, SVR was 84.8% (207 of 244). SVR was 88.5% (207 of 234) among participants who attended 12-week follow up appointment for HCV RNA testing. In multivariate analyses, SVR was significantly associated with adherence (no missed doses) to treatment [vs. missed doses; adjusted OR (aOR) 2.77; 95% confidence interval (95%CI), 1.01-7.51), and genotype (vs. GT1; GT2, aOR 0.27; 95%CI 0.06-1.21; GT3, aOR 1.09; 95%CI 0.27-4.50; and mixed GT, aOR 0.14; 95%CI 0.02-0.97). Conclusion: In this real-life study in a middle-income country, PWID treated for HCV and receiving a simple peer support intervention demonstrated an excellent treatment response and good adherence, not associated with injecting drug use during treatment and OST at treatment initiation.

引用

页码：104 / 111

页数：8

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