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Optimal hepatitis C treatment adherence patterns and sustained virologic response among people who inject drugs: The HERO study

2024; Elsevier BV; Volume: 80; Issue: 5 Linguagem: Inglês

10.1016/j.jhep.2023.12.020

1600-0641

Moonseong Heo, Brianna L. Norton, Irene Pericot‐Valverde, Shruti H. Mehta, Judith I. Tsui, Lynn E. Taylor, Paula J. Lum, Judith Feinberg, Arthur Y. Kim, Julia H. Arnsten, Sophie Sprecht-Walsh, Kimberly Page, Alain H. Litwin, Alain H. Litwin, Moonseong Heo, Moonseong Heo, Moonseong Heo, Irene Pericot‐Valverde, Hagan Walker, Ashley Coleman, Shruti H. Mehta, Courtney Borsuk, Brian E. Dickerson, Oluwaseun Falade‐Nwulia, Michael Fingerhood, Taryn Haselhuhn, Angela Mason, Juhi Moon, Yngvild Olsen, Vickie Walters, Arthur Y. Kim, Jillian M. Roche, William A. Schmitt, Virginia Lijewski, Anita Pitts, Syeda Raji, Taniya Silva, F. Evans, Hope Koene, Joelle Brown, Brianna L. Norton, Linda Agyemang, Julia H. Arnsten, Alison Karasz, Paul Meißner, Kiara Lora, Jennifer Hidalgo, Irene Soloway, Karen Jefferson, Joyce Wong, Andrea Kermack, Melissa Stein, Gilian Joseph, Karyn London, Lincoln Allen, Venecia Marte, Tatiana Vera, Romy Alvarez, M. Diane McKee, Paula J. Lum, Ellen Stein, Anne F. Luetkemeyer, Caycee Cullen, Gurjot Gill, Hannah Tierney, Scott Shapiro, Soraya Azari, Joanna Eveland, Daniel Berrner, Pauli Grey, Jordan Akerley, Kimberly Page, Katherine Wagner, Herbert Davis, Alain H. Litwin, Vanessa Jacobsohn, Alain H. Litwin, Lynn E. Taylor, Karen T. Tashima, Sophie Sprecht-Walsh, Aurielle Thomas, Melissa Hordes, Danielle McGregor, Patrick Duryea, Kathryn Weenig, Judith I. Tsui, Kendra L. Blalock, Hyang Nina Kim, Meena S. Ramchandani, Jocelyn James, K. Michelle Peavy, Paul Grekin, Michael Ninburg, Judith Feinberg, Samuel T. Wilkinson, Danielle Thomas, Lacey Kelley, Andrea Calkins, Gabrielle Henry, Alice Ashler, Eyasu H. Teshale, Sebastian Seiguer, Lauren Brown, Katrina Rios, James Spellman, Daniel P. Raymond, Susan Beane, Richard D. Marks, Tracy Swan, Charles Walworth, Yolanda Lie, Jacqueline D. Reeves, Walter P. Ginter, Jeanne Devin, Ryan Clary, Tina Broder, Bekeela Davila, Nirah Johnson, U H Shahera Khatun, Colleen Flanigan, Rehab Ahmed, Bob Polluck, Serene Mastrianni, James P. Morton, Emily M. Baldwin, Rick L. Pesano, Charissa Fotinos, Douglas N. Fish, James T. Becker, John W. Ward, Mark W. Parrino, Carleen Maxwell,

Hepatitis B Virus Studies

Background Direct-acting antivirals (DAA) are highly effective for treating hepatitis C virus (HCV) infection even among people who inject drugs (PWID). Yet, little is known about patients' adherence patterns and association with sustained virologic response (SVR) rates. We aimed to summarize various adherence patterns and determine their associations with SVR. Methods Electronic blister packs were used to measure daily adherence to once-a-day sofosbuvir/velpatasvir during the 12-week treatment period among active PWIDs. Blister pack data were available for 496 participants who initiated DAA, and had ascertained SVR status. Adherence was summarized in multiple patterns, such as total adherent days, consecutive missed days, and early discontinuations. Thresholds for adherence patterns associated with >90% SVR rates were also determined. Results The overall SVR rate was 92.7% with median 75% adherence rate. All adherence patterns indicating greater adherence were significantly associated with achieving SVR. Participant groups with 42/84 (50%) or more adherent days, or less than 26 consecutive missed days achieved >90% SVR rate. When adherence was stratified by <50% versus ≥50%, only among those with <50% adherence, greater total adherent days during 9-12 weeks, and no early discontinuation were significantly associated with higher SVR rate. Participants with first month discontinuation and ≥2 weeks of treatment interruption had low SVR rates, 25% and 85%, respectively. However, greater adherent days were significantly associated with SVR (aOR = 1.10 (1.04, 1.16), p<.001) even among participant with ≥14 consecutive missed days. Conclusions Although suboptimal adherence can still result high SVR rates among PWID population, encouraging patients to take as much medication as possible, with fewer than 2 weeks consecutive missed days, and without early discontinuation, was found to be important for achieving SVR. Clinical Trial Number NCT02824640