Treat Hepatitis C Regardless of Drug Use

Injection drug use should not prevent patients with hepatitis C virus (HCV) infection from receiving treatment, according to the results of a recent study.

Although guidelines no longer exclude individuals who inject drugs from treatment for hepatitis C, a reluctance to offer treatment to these patients remains.
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In order to evaluate the efficacy of sofosbuvir and velpatasvir therapy in patients with chronic HCV infection who are also injected drug users, researchers conducted an open-label, single-arm phase 4 trial in which 103 participants were recruited. Of the participants, 59% were receiving opioid substitution therapy, 74% injected within the past month, and 26% injected at least daily in the past month. 

Participants received oral sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks, given in weekly electronic blister packs to record time and date of dosage.

Overall, 94% of participants achieved SVR12, while 3 participants with an end-of-treatment response did not achieve SVR, 2 were lost to follow-up, and 1 had reinfection.

“HCV treatment should be offered to people who inject drugs, irrespective of ongoing drug use. Recent injection drug use should not be used as a reason to withhold reimbursement of HCV therapy,” the researchers concluded.

—Michael Potts

Reference:

Grebely J, Dalgard O, Conway B, et al. Sofosbuvir and velpatasvir for hepatitis C virus infection in people with recent injection drug use (SIMPLIFY): an open-label, single-arm, phase 4, multicentre trial. Lancet Gastro Hepatol. 2018;3(3)153-161.