Community-Based HCV Therapy With Sofosbuvir and Velpatasvir in The Inner City

Author: Brian Conway Leo Yamamoto Shawn Sharma Rossitta Yung David Truong Ginny Liu

Theme: Models of Care Year: 2022

The SIMPLIFY study demonstrated that sofosbuvir/velpatasvir (S/V) can be used to treat Hepatitis C
Virus (HCV) infection among active drug users, achieving sustained virologic response (SVR) 12 rates
comparable to those achieved in clinical trials enrolling other patient populations. There remains a need
to replicate these results in more vulnerable populations, including those using fentanyl and not
currently engaged in health care.
The purpose of this project is to identify and successfully engage HCV-infected PWUD in a
multidisciplinary model of care to maximize the likelihood of HCV treatment initiation. In this context, to
determine the efficacy of a 12-week course of sofosbuvir/velpatasvir (rate and correlates of
achievement of SVR12).
Through dedicated outreach events, we identified HCV-infected patients who were not currently
engaged in health care. We offered them the opportunity to enrol in a multidisciplinary program to
address medical-, psychological-, social- and addiction-related needs and provide S/V therapy with daily
or weekly supervision of adherence, as appropriate. The endpoint of this preliminary analysis is the
achievement of SVR12 in those who initiated therapy.
We identified and enrolled 172 eligible HCV-infected treatment-naïve subjects. HCV diagnosis was
documented 1-41 years before enrolment. Key demographic characteristics include: 126 (73%) male,
median age 47 (23-75) years, F0/1 (120, 70%), ≥ F2 (52, 30%), opiate/cocaine/amphetamine use
(126/66/112,73%/38%/65%). Once enrolled in care, 38 (22%) initiated addiction care with opiate agonist
therapy. Of 142 who initiated treatment, 95 were available at the SVR12 time point to date. Of these, 88
achieved a cure. The main reasons an endpoint was not measured included 3 overdose-related deaths
prior to SVR 12 and 4 disengaged from care. There were no cases of virologic failure or relapse.

Through dedicated initiatives, it is possible to identify vulnerable inner-city residents who
were previously diagnosed with HCV infection and had never been offered treatment. These initiatives,
combined with dedicated programs to provide HCV treatment in an optimized manner, must be
considered to achieve HCV elimination in this unique population.
Disclosure of Interest:
B. Conway Grant / Research support for: AbbVie, Gilead, Indivior, Merck, Sanofi Pasteur and ViiV
Healthcare, L. Yamamoto: None Declared, S. Sharma: None Declared, R. Yung: None Declared, G. Liu:
None Declared, D. Truong: None Declared.

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