Efficacy Of Pegylated-Interferon And Ribavirin (Pr) In Persons Who Inject Drugs (Pwid): 3-Years’ Experience Of One Inpatient Rehabilitation Facility

Author: Papadopoulos N, Deutsch M, Kalliaropoulos A, Gonzalez BM, Kouloulias H, Spilioti S, Kyrousis A

Theme: Clinical Research Year: 2017

Background: The prevalence of chronic hepatitis C (CHC) among PWID is estimated to be in the range of 40-80%. Antiviral treatment rates in this group of patients have been low despite the evidence that outcomes (sustained virological response-SVR) can be as good as in patients who have no history of drug use.
We aimed to determine the percentage of CHC and the efficacy of PR treatment in PWID’s of an inpatient rehabilitation center of the Psychiatric Hospital of Attica in Athens, Greece.
Methods: We retrospectively enrolled 80 patients (all men, mean age: 35.5 ± 5.5 years) who joined our inpatient rehabilitation facility between January 2013 and December 2016.
Results: Among the 80 patients included, 35 (44%) were anti-HCV positive and 32/35 (91.5%) were further tested with HCV RNA. Finally, 27/32 (84.5%) were diagnosed with CHC (positive HCV RNA). The mean HCV RNA at diagnosis was 1.7Χ106±4.5X106IU/ml with genotypes: 1; 4/27 (15%), 2; 1/27 (4%), 3; 16/27 (59.5%), 4; 2/27 (7.5%), other / unknown / mixed; 3/27 (11%). Treatment with PR has been initiated in 21/27 (78%). 14/21 (67%) patients completed treatment, 5/21 (24%) are still under treatment, one patient (4.5%) did not complete because of side effects and one patient (4.5%) has been lost due to non-adherence. Among patients who completed treatment, 13/14 (93%) had undetectable HCV RNA at the end of treatment (ETR), 10/14 (72%) achieved SVR, 2/14 (14%) have not yet been tested for SVR and 2/14 (14%) had relapsed. Excluding the 2 patients who have not yet been tested, the SVR rate is 10/12 (83.5%).
Conclusion: Below 50% of the patients in this cohort had anti HCV positive. A significant proportion (60%) of anti-HCV patients have been treated with PR. The majority of these young patients completed treatment without major complications and most of them achieved SVR.

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