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Erschienen in: Wiener klinische Wochenschrift 13-14/2021

25.05.2021 | original article

Challenges in hepatitis C elimination despite highly effective antiviral agents in patients with and without intravenous drug use

verfasst von: Simona Bota, Marcel Razpotnik, Florian Hucke, Christian Urak, Kerstin Flatscher, Prim. Univ. Prof. Dr. Markus Peck-Radosavljevic

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 13-14/2021

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Summary

Aim

To assess the adherence to treatment, sustained virologic response (SVR) rate, and reinfection rate in hepatitis C patients with and without intravenous drug use.

Methods

This retrospective study included hepatitis C patients, evaluated and treated in our hepatology outpatient clinic between January 2014 and October 2019.
The following information was extracted from the patient’s file: the presence of positive viral load for hepatitis C virus (HCV), active and recent (in the last 6 months) use of i.v. drugs, HCV genotype, treatment regimen, SVR, HCV reinfection rate, coinfection with human immunodeficiency virus (HIV) and ongoing opioid substitution therapy (OST).

Results

We included 431 hepatitis C patients, 234 people who inject drugs (PWID) and 197 non-PWID. Most patients were treated with direct-acting antivirals (DAA) only.
The rate of documented SVR by treated patients was significantly higher in the non-PWID cohort (91.5% vs. 61.5%, p < 0.0001), while noncompliance (did not show up to start treatment) rate or refusal of treatment was significantly higher in the PWID cohort (19.4% vs. 8.9%, p = 0.004).
In the PWID cohort, younger age and recent (in the last 6 months) or ongoing i.v. drug use was associated with noncompliance: 31.1 ± 8.4 years vs. 35.8 ± 10.6 years (p = 0.02) and 33.3% vs. 12.8% (p = 0.0008), respectively.
Ongoing OST was associated with better compliance: 61.1% vs. 46.1% (p = 0.04).

Conclusion

To achieve elimination of hepatitis C better treatment strategies are needed, especially in PWIDs.

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Metadaten
Titel
Challenges in hepatitis C elimination despite highly effective antiviral agents in patients with and without intravenous drug use
verfasst von
Simona Bota
Marcel Razpotnik
Florian Hucke
Christian Urak
Kerstin Flatscher
Prim. Univ. Prof. Dr. Markus Peck-Radosavljevic
Publikationsdatum
25.05.2021
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 13-14/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-021-01868-1