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Sofosbuvir-based therapy achieves excellent SVR12 rates among people who inject drugs in the Ukraine
Michael Carter, 2016-12-07 07:30:00
People who inject
drugs (PWID) can have an excellent response to sofosbuvir-based therapy for
hepatitis C virus (HCV) infection, Ukrainian research presented to the recent
2016 AASLD Liver Meeting shows.
Overall, 93% of
people had a sustained virological response 12 weeks (SVR12) after the
completion of therapy. Most people had co-infection with HIV. Individuals
received peer support and support from non-governmental organisations (NGOs).
Since June 2016,
the Ukrainian Alliance for Public Health has been providing sofosbuvir-based
HCV therapy to at-risk populations. As of October 2016, 1192 people have been
provided with therapy, with 80% of treated people being PWIDs.
reported on the treatment outcomes of 456 people who started therapy between
July 2015 and April 2016. Outcomes were stratified according to HCV genotype.
The majority of individuals (89%) had co-infection with HIV, and almost all these individuals
(97%) were taking antiretroviral therapy. A minority of people (14%) had
previous experience of interferon-based HCV treatment and 8% were receiving
opioid substitution therapy. A fifth had
a history of tuberculosis. The median age was 39 years and 81% of people were
male. As regards fibrosis stage, 11% of individuals were F1, 39% F2, 26% F3 and
24% F4. Approximately half (n = 231) carried HCV genotype 1, 34 had
genotype 2 infection, 185 had genotype 3 and six individuals had genotype 4.
Care was provided
by a multidisciplinary team, involving healthcare professionals, social workers
Most people (n =
379) received therapy consisting of sofosbuvir in combination with pegylated
interferon and ribavirin, with treatment lasting 12 weeks.
The overall SVR12
rate was 93%, with 94% of people treated with sofosbuvir, pegylated
interferon and ribavirin attaining this outcome.
All six people
with genotype 4 attained a SVR12, as did 97% of individuals with genotype 3,
91% of people with genotype 1 and 82% of people with genotype 4.
HCV treatment in PWID population shows high cure rates in all fibrosis stages
and genotypes,” conclude the investigators. “Re-infection interventions should
be included as one of the obligatory activities for active PWID.”