Nonadherence to Ledipasvir/Sofosbuvir Did Not Predict Sustained Virologic Response in a Randomized Controlled Trial of Human Immunodeficiency Virus/Hepatitis C Virus Coinfected Persons Who Use Drugs
| Autor: | Lilian Arteaga, Kathleen M Ward, Kayla Herne, Shruti H. Mehta, Stephanie Katz, Catherine G. Sutcliffe, Mark S. Sulkowski, Carl A. Latkin, Juhi Moon, Taryn Haselhuhn, Oluwaseun Falade-Nwulia, Sherilyn Brinkley, Robert K. Brooner |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Ledipasvir
medicine.medical_specialty Sofosbuvir Sustained Virologic Response Substance-Related Disorders Hepatitis C virus Pharmacy HIV Infections Hepacivirus medicine.disease_cause Antiviral Agents law.invention Heroin chemistry.chemical_compound Major Articles and Brief Reports Randomized controlled trial law Internal medicine medicine Immunology and Allergy Humans Fluorenes business.industry Coinfection HIV Hepatitis C Chronic medicine.disease Hepatitis C Infectious Diseases Treatment Outcome chemistry Pharmaceutical Preparations Pill Benzimidazoles business medicine.drug |
| Zdroj: | J Infect Dis |
| Popis: | Background Eliminating hepatitis C virus (HCV) will require effective treatment delivery to persons with substance use disorders (SUDs). We evaluated the relationship between ledipasvir/sofosbuvir treatment persistence (receiving 84 tablets), adherence, and sustained virologic response (SVR) in persons with human immunodeficiency virus (HIV)/HCV coinfection. Methods Of the 144 participants with HIV/HCV and SUDs, 110 initiated a 12-week treatment course under 1 of 3 conditions (usual care, peer mentors, and cash incentives). We used self-report, pharmacy pill counts, and expected date of refill to examine adherence. Persistent participants were categorized as high adherence (taking ≥90% of doses) or low adherence (taking Results Most participants persisted on treatment after initiation (n = 105), with 95% (n = 100) achieving SVR. One third (34%) of participants had moderate/heavy alcohol use by the biomarker phosphatidylethanol ([Peth] ≥50 ng/mL), and 44% had urine toxicology positive for cocaine or heroin at enrollment. The proportion of persons with high adherence was 72% (n = 76), and the proportion of persons with low adherence was 28%. Although low adherence was associated with moderate/heavy alcohol use by PEth (relative risk = 2.77; 95% confidence interval, 1.50–5.12), SVR did not vary according to adherence (P = .702), and most participants (97%) with low adherence achieved SVR. Conclusions Treatment persistence led to high SVR rates among persons with HIV/HCV, despite imperfect adherence and SUDs. |
| Databáze: | OpenAIRE |
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