New Directly Acting Antiviral Therapy Of HCV Infected People Who Injected Drugs: Real Life Experience From Turkey

Author: Ucbilek E, Sahin Horasan E

Theme: Clinical Research Year: 2018

Background: HCV infection in people who injected drugs(PWID) are a special care group. Their HCV genotypes are different from the other HCV infected people and their therapy adherence are also low. Directly Acting Antivirals(DAAs) are easy-to-use drugs than interferon based regimens. The aim of this study is to assess safety and efficacy of DAA treatment among PWID. Methods: HCV infected PWID patients treated with DAAs between July 2016-January 2018 in Mersin University Medical Faculty Gastroenterology and Infectious Diseases Clinics. Therapy options were Sofosbuvir (SOF) ± Ledipasvir ± Ribavirin and Ombitasvir/Paritaprevir/Ritonavir (OBV/PTV/r) ± Dasabuvir ± Ribavirin regimens for 12/24 weeks. Results: Thirty-five patients included the study. 34 patients have reached to posttreatment 12 weeks. Mean age was 28 years. All patients were men. 24 patients were receiving opioid substitution therapy. Genotype(G) distrubition was as follows: G1:16 patients (46%)(G1a:11, G1b:1, undefined G1:4); G2:6 patients(17%); G3:11 patients(31%) and G4:1 patient(3%). 28 patients were treatment naive and 7 patients were treatment experienced. Liver biopsy were performed to 28 patients. The mean fibrosis stage (according to ISHAK) was 2.6(± 0.73). 23 patients was treated with SOF based and 12 patients was OBV/PTV/r based regimens. Adherence to therapy was 100% for 29 patients (83%). The remaining 6 patients(17%) used drugs irregularly (2 patients were arrested and they couldn’t use drugs 15 and 25 days), but all of them finished the drug boxes. Overall SVR rate was 34/35 (97%). There hasn’t been any adverse drug events among this patients. The remaining one patient has died due to the overdose of IV drug. This patient’s 12th week HCV-RNA level was negative. Conclusion: This study shows a real life experience from Turkey in a special group of HCV patients. DAAs are highly effective in difficult-to-treat HCV infected PWID even they have low adherence to therapy. All drugs seem safe in this patient population. Disclosure of Interest Statement: The authors have no disclosure.

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