Research Supports Hep C Treatment for Injection Drug Users

Treating people who use drugs and have hepatitis C virus (HCV) infection is the key to stopping the spread of the virus, but barriers prevent this population from accessing treatment, according to a presentation at the 5th International Symposium on Hepatitis C Care in Substance Users, held in Oslo, Norway, September 7-9, 2016.

Treatment for drug users—especially those who inject drugs—plays a pivotal role in reducing HCV transmission. Although this population accounts for the majority of new infections, they are often excluded from accessing new treatments. Among the reasons for this exclusion are the price of medications, fears about poor adherence, fears about reinfection, and concerns over efficacy.
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One study discussed, the C-EDGE CO-STAR Clinical Trial, is the largest study of new HCV curative therapies. It assessed adherence and drug use in 301 HCV-infected people who were on opioid-agonist therapy and who received elbasvir/grazoprevir fixed-dose combination for 12 weeks.

Results showed that illicit drug use before and during HCV treatment had no impact on the effectiveness of the treatment, and that reinfection rates were low and adherence to treatment was high.

Other studies had similar findings:

  • Mathematical modeling found that even moderate levels of treatment uptake in people who use drugs could offer considerable prevention benefits.
  • Among studies from Scotland, Australia, and Canada, 3- to 5-fold treatment uptake among people who inject drugs could halve HCV prevalence in 15 years.
  • Studies in the United Kingdom and France suggest that realistic treatment scale-up could achieve a 15% to 50% reduction in chronic HCV prevalence in 10 years.

“Providing treatment to people who inject drugs, integrated with harm reduction programs and linkage to care, is the key to hepatitis C program success,” the investigators concluded.

“Countries such as Australia and France have taken the lead in adopting evidence-based policies that will save lives. Now it’s time for other countries, including the US and Norway, to follow their lead and allow all patients with chronic hepatitis C to be treated with the new drugs.”

—Amanda Balbi

Reference:

No treatment, no elimination says new research: people who use drugs hold key to ending hepatitis C [news release]. Oslo, Norway: 5th International Symposium on Hepatitis Care in Substance Users; September 7, 2016. https://www.eiseverywhere.com/ehome/index.php?eventid=149095&tabid=451717. Accessed September 15, 2016.