Virologic Response and Reinfection Following HCV Treatment among Hospitalized People Who Inject Drugs: Follow-Up Data from the OPPORTUNI-C Trial.

Autor: Malme KB; Department of Infectious Diseases, Akershus University Hospital, 1478 Lørenskog, Norway.; Institute of Clinical Medicine, University of Oslo, 0371 Oslo, Norway., Stene-Johansen K; Department of Virology, Norwegian Institute of Public Health, 0304 Oslo, Norway., Klundby I; Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway., Backe Ø; Agency for Social and Welfare Services, 0182 Oslo, Norway., Foshaug T; Agency for Social and Welfare Services, 0182 Oslo, Norway., Greve MH; Foundation of Franciscan Aid, Nurses on Wheels, 0651 Oslo, Norway., Pihl CM; Department of Medicine, Lovisenberg Diaconal Hospital, 0456 Oslo, Norway., Finbråten AK; Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, 0456 Oslo, Norway.; Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway., Dalgard O; Department of Infectious Diseases, Akershus University Hospital, 1478 Lørenskog, Norway.; Institute of Clinical Medicine, University of Oslo, 0371 Oslo, Norway., Midgard H; Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway.
Jazyk: angličtina
Zdroj: Viruses [Viruses] 2024 May 27; Vol. 16 (6). Date of Electronic Publication: 2024 May 27.
DOI: 10.3390/v16060858
Abstrakt: Treatment of hepatitis C among people who inject drugs (PWID) may be complicated by loss to follow-up and reinfection. We aimed to evaluate sustained virologic response (SVR) and reinfection, and to validate complete pharmacy dispensation as a proxy for cure among PWID enrolled in a trial of opportunistic HCV treatment. Data were obtained by reviewing the electronic patient files and supplemented by outreach HCV RNA testing. Reinfection was defined based on clinical, behavioral, and virological data. Intention to treat SVR ≥ 4 within 2 years after enrolment was accomplished by 59 of 98 (60% [95% CI 50-70]) during intervention conditions (opportunistic treatment) and by 57 of 102 (56% [95% CI 46-66]) during control conditions (outpatient treatment). The time to end of treatment response (ETR) or SVR ≥ 4 was shorter among intervention participants (HR 1.55 [1.08-2.22]; p = 0.016). Of participants with complete dispensation, 132 of 145 (91%) achieved ETR or SVR > 4 (OR 12.7 [95% CI 4.3-37.8]; p < 0.001). Four cases of reinfection were identified (incidence 3.8/100 PY [95% CI 1.0-9.7]). Although SVR was similar, the time to virologic cure was shorter among intervention participants. Complete dispensation is a valid correlate for cure among individuals at risk of loss to follow-up. Reinfection following successful treatment remains a concern.
Competing Interests: A.-K.F., K.S.-J., C.M.P., M.H.G., I.K. and T.F. declare no conflicts of interests. OD has received lecture, research support and consultancy fees from MSD and Abbvie. HM has received lecture and consultancy fees from Gilead, MSD, Abbvie and Novo Nordisk. KBM has received lecture fees from Gilead. ØB and TSF has received lecture fees from AbbVie, MSD, and Gilead. No pharmaceutical grants were received in the development of this study.
Databáze: MEDLINE
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