Paritaprevir, ritonavir, ombitasvir, and dasabuvir with and without ribavirin in people with HCV genotype 1 and recent injecting drug use or receiving opioid substitution therapy.

Autor: Grebely J; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia. Electronic address: jgrebely@kirby.unsw.edu.au., Conway B; Vancouver Infectious Diseases Center, Vancouver, Canada., Cunningham EB; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Fraser C; Coolaid Community Health Centre, Victoria, Canada., Moriggia A; Fondazione Epatocentro Ticino, Lugano, Switzerland., Gane E; Auckland Hospital, Auckland, New Zealand., Stedman C; Christchurch Hospital and University of Otago, Christchurch, New Zealand., Cooper C; Ottawa Hospital Research Institute, Ottawa, Canada., Castro E; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland., Schmid P; Kantonsspital St Gallen, St Gallen, Switzerland., Petoumenos K; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Hajarizadeh B; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Marks P; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Erratt A; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Dalgard O; Akershus University Hospital, Oslo, Norway., Lacombe K; Inserm UMR-S1136, Sorbonne Université, Hôpital Saint-Antoine, Paris, France., Feld JJ; Toronto General Hospital, Toronto, Canada., Bruneau J; Centre Hospitalier de l'Université de Montréal, Montréal, Canada., Daulouede JP; Csapa Bizia, Bayonne, France., Powis J; South Riverdale Community Health Centre, Toronto, Canada., Bruggmann P; Arud Centres for Addiction Medicine, Zurich, Switzerland., Matthews GV; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Kronborg I; Footscray Hospital, Footscray, Australia., Shaw D; Royal Adelaide Hospital, Adelaide, Australia., Dunlop A; Newcastle Pharmacotherapy Service, Newcastle, Australia., Hellard M; The Burnet Institute, Melbourne, Australia., Applegate TL; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia., Crawford S; Harm Reduction Victoria, Melbourne, Australia., Dore GJ; The Kirby Institute, UNSW Sydney, Wallace Wurth Building, UNSW NSW 2052, Australia.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2018 Dec; Vol. 62, pp. 94-103. Date of Electronic Publication: 2018 Oct 29.
DOI: 10.1016/j.drugpo.2018.10.004
Abstrakt: Background: Direct-acting antiviral therapy for hepatitis C virus (HCV) infection is safe and effective, but there are little data among people who have recently injected drugs. This study evaluated the efficacy, and safety of paritaprevir/ritonavir, ombitasvir, dasabuvir with or without ribavirin for chronic HCV genotype (G) 1 among people with recent injecting drug use and/or receiving OST.
Methods: D3FEAT is an international open-label study that recruited treatment-naïve participants with recent injecting drug use (previous 6 months) and/or receiving OST with chronic HCV G1 infection between June 2016 and February 2017 in seven countries. Participants received paritaprevir/ritonavir, ombitasvir, dasabuvir with (G1a) or without ribavirin (G1b) administered twice daily in a one-week electronic blister pack (records timing of each dose) for 12 weeks. The primary endpoint was undetectable HCV RNA 12 weeks post-treatment (SVR12).
Results: Among 87 participants (median age 48 years), 23% were female, 8% had cirrhosis, and 90% had G1a. Overall, 71% were receiving OST, 61% injected in the previous six months, 45% injected in the previous month, and 15% injected > daily. Treatment completion was 97% (84 of 87). There were no virological breakthroughs, but three discontinuations (loss to follow-up, n = 1; non-adherence, n = 1; incarceration, n = 1). SVR was 91% (79 of 87, 95% CI, 83%-96%). Five participants who completed treatment did not have SVR (loss to follow-up, n = 1; death, n = 1; virologic relapse, n = 3). Drug use prior to and during treatment did not impact SVR12. Treatment-related adverse events were observed in 46 (53%) patients (six grade 3, no grade 4). Five (6%) patients had at least one serious adverse event (two possibly/probably related to therapy; nausea and myoclonus). Two cases of reinfection were observed.
Conclusion: Paritaprevir/ritonavir, ombitasvir, and dasabuvir with or without ribavirin for 12 weeks is effective among people with HCV genotype 1 with recent injecting drug use and/or receiving OST.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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