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Title: | Belgian experience with direct acting antivirals in people who inject drugs | Authors: | BIELEN, Rob Moreno, Christophe Van Vlierberghe, Hans Bourgeois, Stefan Mulkay, Jean-Pierre Vanwolleghem, Thomas Verlinden, Wim Brixko, Christian Decaestecker, Jochen De Galocsy, Chantal Janssens, Filip Cool, Mike Van Overbeke, Lode Van Steenkiste, Christophe D'heygere, Francois COOLS, Wilfried Nevens, Frederik ROBAEYS, Geert |
Issue Date: | 2017 | Publisher: | ELSEVIER IRELAND LTD | Source: | DRUG AND ALCOHOL DEPENDENCE, 177, p. 214-220 | Abstract: | Background and aim: Hepatitis C viral infection (HCV) has become a curable disease due to the development of direct acting antivirals (DAA). The WHO has set a target to eliminate HCV completely. Therefore, people who inject drugs (PWID) also need to be treated. In this study, we compared the real-life uptake and outcome of DAA treatment for HCV in PWID and non-PWID. Methods: We performed a nation-wide, retrospective cohort study in 15 hospitals. All patients who were treated with simeprevir-sofosbuvir, daclatasvir-sofosbuvir, or ombitasvir/paritaprevir ritonavir dasabuvir between December 2013 and November 2015 were included. Results: The study population consisted of 579 patients: 115 PWID (19.9%) and 464 non-PWID (80.1%). Of the PWID 18 were active PWID (15.6%), 35 still received opiate substitution therapy (OST) (30.4%) and 62 were former PWID without OST (53.9%). PWID were more infected with genotype la and 3 (p = 0.001). There were equal rates of side-effects (44.7% vs. 46.6%; p = 0.847), similar rates of treatment completion (95.7% vs 98.1%; p = 0.244) and SVR (93.0% vs 94.8%; p = 0.430) between PWID and non-PWID, respectively. Conclusion: PWID, especially active users, are underserved for DAA treatment in real life in Belgium. Reimbursement criteria based on fibrosis stage make it difficult to treat PWID. Treatment adherence is similar in PWID and the general population, even in patients with active abuse. DAA were safe and effective in PWID despite the higher prevalence of difficult-to-treat genotypes. Based on these data more efforts to treat PWID are needed and policy changes are necessary to reach the WHO targets. | Notes: | [Bielen, Rob] Hasselt Univ, Fac Med & Life Sci, Dept Gastroenterol & Hepatol, Ziekenhuis Oost Limburg, Genk, Belgium. [Moreno, Christophe] Erasme Univ Hosp, Dept Gastroenterol & Hepatopancreatol, Brussels, Belgium. [Van Vlierberghe, Hans] Univ Hosp Gent, Dept Hepatol & Gastroenterol, Ghent, Belgium. [Bourgeois, Stefan] ZNA Stuivenberg, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Mulkay, Jean-Pierre] Hop St Pierre & Erasme, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Vanwolleghem, Thomas; Verlinden, Wim] Univ Hosp UZ Antwerpen, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Brixko, Christian] CHR Citadelle, Dept Gastroenterol & Digest Oncol, Liege, Belgium. [Decaestecker, Jochen] KULeuven, Dept Gastroenterol & Hepatol, Univ Hosp, AZ Delta, Roeselare, Leuven, Belgium. [De Galocsy, Chantal] Hop HIS Bracops, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Janssens, Filip] KULeuven, Jessa Hosp, Dept Gastroenterol & Hepatol, Univ Hosp, Hasselt, Leuven, Belgium. [Cool, Mike] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, AZ Damiaan, Oostende, Leuven, Belgium. [Van Overbeke, Lode] AZ Sint Maarten, Dept Gastroenterol & Hepatol, Mechelen, Belgium. [Van Steenkiste, Christophe] Univ Hosp Gent, Dept Gastroenterol & Hepatol, AZ Maria Middelares, Ghent, Belgium. [D'heygere, Francois] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, AZ Groeninge, Kortrijk, Leuven, Belgium. [Cools, Wilfried] Hasselt Univ, Ctr Stat, Fac Sci, Diepenbeek, Belgium. [Nevens, Frederik] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, Leuven, Belgium. [Robaeys, Geert] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, Ziekenhuis Oost Limbu, Leuven, Belgium. | Keywords: | Direct acting antiviral therapy; Hepatitis c virus; Intravenous drug use; People who inject drugs; Treatment uptake;direct acting antiviral therapy; hepatitis c virus; intravenous drug use; people who inject drugs; treatment uptake | Document URI: | http://hdl.handle.net/1942/24392 | ISSN: | 0376-8716 | e-ISSN: | 1879-0046 | DOI: | 10.1016/j.drugalcdep.2017.04.003 | ISI #: | 000407666100029 | Rights: | © 2017 Elsevier B.V. All rights reserved. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
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