Adherence to treatment for recently acquired hepatitis C virus (HCV) infection among injecting drug users
Jason Grebely, Gail V Matthews, Margaret Hellard, David Shaw, Ingrid van Beek, Kathy Petoumenos, Maryam Alavi, Barbara Yeung, Paul S Haber, Andrew R Lloyd, John M Kaldor, Gregory J Dore, ATAHC Study Group, John Kaldor, Gregory Dore, Gail Matthews, Pip Marks, Andrew Lloyd, Margaret Hellard, Paul Haber, Rose French, Peter White, William Rawlinson, Carolyn Day, Ingrid van Beek, Geoff McCaughan, Annie Madden, Kate Dolan, Geoff Farrell, Nick Crofts, William Sievert, David Baker, John Kaldor, Gregory Dore, Gail Matthews, Pip Marks, Barbara Yeung, Jason Grebely, Brian Acraman, Kathy Petoumenos, Janaki Amin, Carolyn Day, Anna Doab, Therese Carroll, Margaret Hellard, Oanh Nguyen, Andrew Lloyd, Suzy Teutsch, Hui Li, Alieen Oon, Barbara Cameron, William Rawlinson, Brendan Jacka, Yong Pan, Rose French, Jacqueline Flynn, Kylie Goy, Gregory Dore, Margaret Hellard, David Shaw, Paul Haber, Joe Sasadeusz, Darrell Crawford, Ingrid van Beek, Nghi Phung, Jacob George, Mark Bloch, David Baker, Brian Hughes, Lindsay Mollison, Stuart Roberts, William Sievert, Paul Desmond, Jason Grebely, Gail V Matthews, Margaret Hellard, David Shaw, Ingrid van Beek, Kathy Petoumenos, Maryam Alavi, Barbara Yeung, Paul S Haber, Andrew R Lloyd, John M Kaldor, Gregory J Dore, ATAHC Study Group, John Kaldor, Gregory Dore, Gail Matthews, Pip Marks, Andrew Lloyd, Margaret Hellard, Paul Haber, Rose French, Peter White, William Rawlinson, Carolyn Day, Ingrid van Beek, Geoff McCaughan, Annie Madden, Kate Dolan, Geoff Farrell, Nick Crofts, William Sievert, David Baker, John Kaldor, Gregory Dore, Gail Matthews, Pip Marks, Barbara Yeung, Jason Grebely, Brian Acraman, Kathy Petoumenos, Janaki Amin, Carolyn Day, Anna Doab, Therese Carroll, Margaret Hellard, Oanh Nguyen, Andrew Lloyd, Suzy Teutsch, Hui Li, Alieen Oon, Barbara Cameron, William Rawlinson, Brendan Jacka, Yong Pan, Rose French, Jacqueline Flynn, Kylie Goy, Gregory Dore, Margaret Hellard, David Shaw, Paul Haber, Joe Sasadeusz, Darrell Crawford, Ingrid van Beek, Nghi Phung, Jacob George, Mark Bloch, David Baker, Brian Hughes, Lindsay Mollison, Stuart Roberts, William Sievert, Paul Desmond
Abstract
Background & aims: Adherence to HCV therapy impacts sustained virological response (SVR) but there are limited data on adherence, particularly among injecting drug users (IDUs). We assessed 80/80 adherence (≥80% of PEG-IFN doses, ≥80% treatment), on-treatment adherence, and treatment completion in a study of treatment of recent HCV infection (ATAHC).
Methods: Participants with HCV received pegylated interferon (PEG-IFN) alfa-2a (180μg/week, n=74) and those with HCV/HIV received PEG-IFN alfa-2a with ribavirin (n=35), for a planned 24 weeks. Logistic regression analyses were used to identify predictors of PEG-IFN 80/80 adherence.
Results: A total of 109 out of 163 patients received treatment (HCV, n=74; HCV/HIV, n=35), with 75% ever reporting IDU. The proportion with 80/80 PEG-IFN adherence was 82% (n=89). During treatment, 14% missed ≥1 dose (on-treatment adherence=99%). Completion of 0-4, 5-19, 20-23, and all 24 weeks of PEG-IFN therapy occurred in 10% (n=11), 14% (n=15), 6% (n=7) and 70% (n=76) of cases, respectively. Participants with no tertiary education were less likely to have 80/80 PEG-IFN adherence (AOR 0.29, p=0.045). IDU prior to or during treatment did not impact 80/80 PEG-IFN adherence. SVR was higher among those patients with ≥80/80 PEG-IFN adherence (67% vs. 35%, p=0.007), but similar among those with and without missed doses during therapy (73% vs. 60%, p=0.309). SVR in those patients discontinuing therapy between 0-4, 5-19, 20-23, and 24 weeks was 9%, 33%, 43%, and 76%, respectively (p<0.001).
Conclusions: High adherence to treatment for recent HCV was observed, irrespective of IDU prior to, or during, therapy. Sub-optimal PEG-IFN exposure was mainly driven by early treatment discontinuation rather than missed doses during therapy.
Trial registration: ClinicalTrials.gov NCT00192569.
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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Source: PubMed