Adherence to response-guided pegylated interferon and ribavirin for people who inject drugs with hepatitis C virus genotype 2/3 infection: the ACTIVATE study

被引：7

作者：

Cunningham, Evan B. ^{[1
]}

Hajarizadeh, Behzad ^{[1
]}

Dalgard, Olav ^{[2
]}

Amin, Janaki ^{[1
]}

Hellard, Margaret ^{[14
]}

Foster, Graham R. ^{[3
]}

Bruggmann, Philip ^{[4
]}

Conway, Brian ^{[5
]}

Backmund, Markus ^{[6
]}

Robaeys, Geert ^{[7
,8
,9
]}

Swan, Tracy ^{[10
]}

Marks, Philippa S. ^{[1
]}

Quiene, Sophie ^{[1
]}

Applegate, Tanya L. ^{[1
]}

Weltman, Martin ^{[11
]}

Shaw, David ^{[12
]}

Dunlop, Adrian ^{[13
]}

Bruneau, Julie ^{[15
]}

Midgard, Havard ^{[2
]}

Bourgeois, Stefan ^{[16
]}

Thurnheer, Maria Christine ^{[17
]}

Dore, Gregory J. ^{[1
]}

Grebely, Jason ^{[1
]}

机构：

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

[2] Akershus Univ Hosp, Oslo, Norway

[3] Queen Mary Univ London, Liver Unit, London, England

[4] Arud Ctr Addict Med, Zurich, Switzerland

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

[6] Ludwig Maximilians Univ Munchen, Munich, Germany

[7] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium

[8] UZ Leuven, Dept Hepatol, Leuven, Belgium

[9] UHasselt, Hasselt, Belgium

[10] Treatment Act Grp, New York, NY USA

[11] Nepean Hosp, Sydney, NSW, Australia

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

[13] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia

[14] Burnet Inst, Melbourne, Vic, Australia

[15] Ctr Hosp Univ Montreal CRCHUM, Res Ctr, Montreal, PQ, Canada

[16] Stuivenberg ZNA, Antwerp, Belgium

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

来源：

BMC INFECTIOUS DISEASES | 2017年 / 17卷

基金：

英国医学研究理事会;

关键词：

Hepatitis C; Treatment; PWID; Injection drug use; Adherence; USERS; MEDICATION; MANAGEMENT; THERAPY; HCV; EPIDEMIOLOGY; ALCOHOL;

D O I：

10.1186/s12879-017-2517-3

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: The aims of this analysis were to investigate treatment completion and adherence among people with ongoing injecting drug use or receiving opioid substitution therapy (OST) in a study of response-guided therapy for chronic HCV genotypes 2/3 infection. Methods: ACTIVATE was a multicenter clinical trial recruited between 2012 and 2014. Participants with genotypes 2/3 were treated with directly observed peg-interferon alfa-2b (PEG-IFN) and self-administered ribavirin for 12 (undetectable HCV RNA at week 4) or 24 weeks (detectable HCV RNA at week 4). Outcomes included treatment completion, PEG-IFN adherence, ribavirin adherence, and sustained virological response (SVR, undetectable HCV RNA >12 weeks post-treatment). Results: Among 93 people treated, 59% had recently injected drugs (past month), 77% were receiving OST and 56% injected drugs during therapy. Overall, 76% completed treatment. Mean on-treatment adherence to PEG-IFN and ribavirin were 98.2% and 94.6%. Overall, 6% of participants missed > 1 dose of PEG-IFN and 31% took <95% of their prescribed ribavirin., Higher treatment completion was observed among those receiving 12 vs. 24 weeks of treatment (97% vs. 46%, P < 0.001) while the proportion of participants with 95% on-treatment ribavirin adherence was similar between groups (67% vs. 72%, P = 0.664). Receiving 12 weeks of therapy was independently associated with treatment completion. No factors were associated with 95% RBV adherence. Neither recent injecting drug use at baseline nor during therapy was associated with treatment completion or adherence to ribavirin. In adjusted analysis, treatment completion was associated with SVR (aOR 23.9, 95% CI 2.9-193.8). Conclusions: This study demonstrated a high adherence to directly observed PEG-IFN and self-administered ribavirin among people with ongoing injecting drug use or receiving OST. These data also suggest that shortening therapy from 24 to 12 weeks can lead to improved treatment completion. Treatment completion was associated with improved response to therapy.

引用

页数：12

共 27 条

[1] Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United States [J].

Barua, Soumitri ;

Greenwald, Robert ;

Grebely, Jason ;

Dore, Gregory J. ;

Swan, Tracy ;

Taylor, Lynn E. .

ANNALS OF INTERNAL MEDICINE, 2015, 163 (03) :215-+

[2]

Burkhart PV, 2003, J NURS SCHOLARSHIP, V35, P207

[3] The AUDIT alcohol consumption questions (AUDIT-C) - An effective brief screening test for problem drinking [J].

Bush, K ;

Kivlahan, DR ;

McDonell, MB ;

Fihn, SD ;

Bradley, KA .

ARCHIVES OF INTERNAL MEDICINE, 1998, 158 (16) :1789-1795

[4]

CACOUB P, 2008, J HEPATOL S2, V48, pS289

[5] Medication compliance and persistence: Terminology and definitions [J].

Cramer, Joyce A. ;

Roy, Anuja ;

Burrell, Anita ;

Fairchild, Carol J. ;

Fuldeore, Mahesh J. ;

Ollendorf, Daniel A. ;

Wong, Peter K. .

VALUE IN HEALTH, 2008, 11 (01) :44-47

[6]

Dore G, 2015, HEPATOLOGY, V62, p227A

[7]

Formentini E, 2008, HEPATOLOGY, V48, p735A

[8] Influence of the type of pegylated interferon on the onset of depressive and neuropsychiatric symptoms in HIV-HCV coinfected patients [J].

Fumaz, C. R. ;

Munoz-Moreno, J. A. ;

Ballesteros, A. L. ;

Paredes, R. ;

Ferrer, M. J. ;

Salas, A. ;

Fuster, D. ;

Masmitja, E. ;

Perez-Alvarez, N. ;

Gomez, G. ;

Tural, C. ;

Clotet, B. .

AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV, 2007, 19 (01) :138-145

[9]

Grebely J, 2016, IJDP IN PRESS

[10] Recommendations for the management of hepatitis C virus infection among people who inject drugs [J].

Grebely, Jason ;

Robaeys, Geert ;

Bruggmann, Philip ;

Aghemo, Alessio ;

Backmund, Markus ;

Bruneau, Julie ;

Byrne, Jude ;

Dalgard, Olav ;

Feld, Jordan J. ;

Hellard, Margaret ;

Hickman, Matthew ;

Kautz, Achim ;

Litwin, Alain ;

Lloyd, Andrew R. ;

Mauss, Stefan ;

Prins, Maria ;

Swan, Tracy ;

Schaefer, Martin ;

Taylor, Lynn E. ;

Dore, Gregory J. .

INTERNATIONAL JOURNAL OF DRUG POLICY, 2015, 26 (10) :1028-1038

← 1 2 3 →