Adherence to sofosbuvir and velpatasvir among people with chronic HCV infection and recent injection drug use: The SIMPLIFY study

被引：64

作者：

Cunningham, Evan B. ^{[1
]}

Amin, Janaki. ^{[1
,2
]}

Feld, Jordan J. ^{[3
]}

Bruneau, Julie ^{[4
]}

Dalgard, Olav ^{[5
,6
]}

Powis, Jeff ^{[7
]}

Hellard, Margaret ^{[8
,9
]}

Cooper, Curtis ^{[10
]}

Read, Phillip ^{[1
,11
]}

Conway, Brian ^{[12
]}

Dunlop, Adrian J. ^{[13
,14
,15
]}

Norton, Briana ^{[16
,17
]}

Litwin, Alain H. ^{[16
,17
]}

Hajarizadeh, Behzad ^{[1
]}

Thurnheer, Maria Christine ^{[18
]}

Dillon, John F. ^{[19
]}

Weltman, Martin ^{[20
]}

Shaw, David ^{[21
]}

Bruggmann, Philip ^{[22
]}

Gane, Edward ^{[23
]}

Fraser, Chris ^{[24
]}

Marks, Philippa ^{[1
]}

Applegate, Tanya L. ^{[1
]}

Quiene, Sophie ^{[1
]}

Siriragavan, Sharmila ^{[1
]}

Matthews, Gail V. ^{[1
,25
]}

Dore, Gregory J. ^{[1
,25
]}

Grebely, Jason ^{[1
]}

机构：

[1] UNSW Sydney, Kirby Inst, Sydney, NSW, Australia

[2] Macquarie Univ, Fac Med & Hlth Sci, Sydney, NSW, Australia

[3] Toronto Gen Hosp, Toronto, ON, Canada

[4] Ctr Hosp Univ Montreal, Montreal, PQ, Canada

[5] Akershus Univ Hosp, Oslo, Norway

[6] Univ Oslo, Inst Clin Med, Oslo, Norway

[7] South Riverdale Community Hlth Ctr, Toronto, ON, Canada

[8] Burnet Inst, Melbourne, Vic, Australia

[9] Alfred Hosp, Dept Infect Dis, Melbourne, Vic, Australia

[10] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[11] Kirketon Rd Ctr, Sydney, NSW, Australia

[12] Vancouver Infect Dis Ctr, Vancouver, BC, Canada

[13] Hunter New England Local Hlth Dist, Drug & Alcohol Clin Serv, New Lambton Hts, NSW, Australia

[14] Hunter Med Res Inst, Ctr Translat Neurosci & Mental Hlth, Newcastle, NSW, Australia

[15] Univ Newcastle, Newcastle, NSW, Australia

[16] Montefiore Med Ctr, New York, NY USA

[17] Albert Einstein Coll Med, New York, NY USA

[18] Bern Univ Hosp, Dept Infect Dis, Bern, Switzerland

[19] Univ Dundee, Ninewells Hosp & Med Sch, Dundee, Scotland

[20] Nepean Hosp, Penrith, NSW, Australia

[21] Royal Adelaide Hosp, Adelaide, SA, Australia

[22] Arud Ctr Addict Med, Zurich, Switzerland

[23] Auckland City Hosp, Auckland, New Zealand

[24] Coolaid Community Hlth Ctr, Victoria, BC, Canada

[25] St Vincents Hosp, Sydney, NSW, Australia

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2018年 / 62卷

基金：

英国医学研究理事会; 美国国家卫生研究院;

关键词：

HCV; Treatment; PWID; Drug use; Injecting drug users; Compliance; OST; Blister pack; Stimulants; Amphetamine; Cocaine; C VIRUS-INFECTION; CHRONIC HEPATITIS-C; SUBSTITUTION THERAPY ANALYSIS; GENOTYPE 1-INFECTED PATIENTS; MEDICAID REIMBURSEMENT; EFFICACY; RIBAVIRIN; SAFETY; RESTRICTIONS; DASABUVIR;

D O I：

10.1016/j.drugpo.2018.08.013

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: This study investigated treatment adherence among people with recent injecting drug use in a study of sofosbuvir/velpatasvir therapy for HCV infection. Methods: SIMPLIFY is an international open-label, single-arm multicentre study that recruited participants with recent injecting drug use (previous six months) and chronic HCV genotype (G) 1-6 infection between March and October 2016 in seven countries (19 sites). Participants received sofosbuvir/velpatasvir once-daily for 12 weeks administered in a one-week electronic blister pack (records the time and date of each dose) for 12 weeks. We evaluated non-adherence (< 90% adherent) as measured by electronic blister-pack assessed using logistic regression and generalised estimating equations (continuous) with detailed analyses of dosing dynamics. Results: Among 103 participants, 97% (n = 100) completed treatment. Median adherence to therapy was 94%. Overall, 32% (n = 33) were considered non-adherent (< 90% adherence). Adherence significantly decreased over the course of therapy. Recent stimulant injecting (cocaine and/or amphetamines) at treatment initiation and during treatment was independently associated with non-adherence. Inconsistent dose timing (standard deviation of daily dose timing of >= 240 min) was also independently associated with non-adherence to therapy. Factors associated with inconsistent dose timing included lower levels of education and recent stimulant injecting. SVR was similar among adherent and non-adherent populations (94% vs. 94%, P = 0.944). Conclusion: This study demonstrated high adherence to once-daily sofosbuvir/velpatasvir therapy among a population of people with recent injecting drug use. Recent stimulant injecting prior to and during DAA therapy and inconsistent dose-timing during treatment was associated with non-adherence. However, there was no impact of non-adherence on response to therapy, suggesting that adherence is not a significant barrier to successful DAA therapy in people with recent injecting drug use.

引用

页码：14 / 23

页数：10

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