Theme: Clinical Research Year: 2016
REAL WORLD OUTCOMES OF DIRECT ACTING ANTIVIRAL (DAA)THERAPY FOR
HEPATITIS C (HCV) AMONGST PERSONS WHO INJECT DRUGS TREATED IN AN
INNER-CITY HEPATITIS C TREATMENT PROGRAM, VANCOUVER, CANADA
Hull M 1,2,3
, Gallagher L 2
, Pare D 2,3
, Kason D 2
, Persaud S 2
, Nouch S 2,3
, Viljoen M 2
, Zhang W 1
, Bath M 2
, Pauls G
, Barrios R 1,2,3
, Norbury M 2
, Hall D 2,3
1 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
2 Vancouver Coastal Health Authority, Vancouver, Canada
3 University of British Columbia, Vancouver, Canada
Background: Outcomes of direct acting antiviral therapy for HCV in persons who inject
drugs (PWID) treated in a real world setting are not well established. We undertook an
analysis of outcomes of individuals undertaking HCV therapy in an inner city multi-site
treatment program, Vancouver, Canada.
Methods: Data were analyzed from participants followed through the Vancouver
Coastal Health -Vancouver Community HCV Treatment Program offered at three innercity primary care clinics from July 1, 2014 to April 15, 2016. DAA based therapy
included use of combination pegylated interferon/ribavirin (PR) with a DAA, or
interferon-free DAA therapy. Participants were recorded as achieving a sustained
virologic response (SVR12) if HCV RNA was undetectable at 12 weeks following the
end of therapy, or recorded as lost-to follow-up (LTFU) if no results were obtained.
Outcomes for PWID on opiod substitution therapies (OST) and for HIV/HCV co-infected
patients were compared to those not on OST and to HCV mono-infected patients,
Results: Overall 156 (82% male, median age at baseline 54 years (q1-q3 38-59))
individuals initiated HCV therapy (87.8% with history of injection drug use and 53.2% on
OST). Of those treated, 18% were treatment-experienced and 50.6% had evidence of
underlying cirrhosis. For n =118 (75.4%) genotype 1 individuals, 117(99%) received
interferon-free DAAs, (86% sofosbuvir/ledipasvir). For n = 38 (24.4%) genotype 2/3
individuals, 36 (94.7%) received interferon-free DAAs. Of those who have reached their
SVR12 visit (n=87), 85% achieved SVR12, 13% were LTFU at that visit, and only n=2
had documented relapse (both G3, cirrhotic). No differences in LTFU rate were seen for
PWID (p=0.990), those on OST (p=0.494) or for co-infected individuals (p=0.681).
Conclusions: Outcomes attained using DAA therapies are high in a real world setting.
Strategies to improve retention in care post therapy will be important to ensure
appropriate monitoring for treatment failure and re-infection.
Disclosure Statement: Dr. Mark Hull has received grant support from the National
Institute on Drug Abuse (NIDA R01DA031043-01) and has received honoraria paid to
his institution for speaking engagements and/or consultancy meetings from the
following: AbbVie, Bristol Myers Squibb, Gilead, Merck, Ortho-Janssen, and Viiv.