New and Noteworthy
There was a significant reduction in hepatitis C incidence among injection drug users who attended needle and syringe programs in Australia, according to a study in the American Journal of Public Health. As part of a long-term evaluation of the programs, participants completed a survey each year from 1995 to 2010 and were tested for Hep C antibodies. “The decline in new cases of hepatitis C among people who inject drugs coincided with the expansion of programs like opioid substitution therapy and needle and syringe programs, which aim to minimize the spread of blood-borne viruses,” reported one of the researchers. This study is unique in that it followed people who use injection drugs over time. According to another researcher, “it allows us to assess the uptake and impact of prevention and treatment interventions in this group.” (Healio.com, July 2013, in English)
Reinfection rates are high among prisoners who previously cleared Hep C and actively inject drugs, suggests a small study of mostly male prisoners in Catalonia, Spain. Publishing their results in Hepatology, the researchers report that Hep C reinfection rates were also higher among HIV-positive people and people who engaged in more than one risk behaviour after completing Hep C treatment. Methadone maintenance programs are available in all of the prisons included in the study. Needle and syringe exchanges are available in three of the four prisons. “Strengthening preventative measures for those with ongoing or at risk of injection drug use relapse, should be a priority at diagnosis, and during and after treatment. Such measures should include reinforcing harm reduction strategies combining needles/syringes exchange and methadone maintenance treatment, multidisciplinary education and counselling on key issues regarding risk practices, maximizing treatment uptake while in prison and reinforcing retention in community-based treatment programs after release,” say the researchers. (aidsmap.com, July 2013, in English)
Nearly three-quarters of HIV/HCV coinfected patients treated with peg-interferon, ribavirin and telaprevir (Incivek) had undetectable amounts of Hep C virus 24 weeks after starting treatment, reported French researchers at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013), in Kuala Lumpur, Malaysia. The study looked at treatment outcomes for triple therapy with telaprevir (Incivek) or boceprevir (Victrelis) in a “real-life” clinical setting for people coinfected with HIV and Hep C. Results from this “real life” setting were similar to those found in the more controlled clinical trials that are conducted during the drug approval process.
“The rate of virological responses at week 24 was high (74% for telaprevir and 60% for boceprevir), with a trend for a better virological response in genotype 1b and non-cirrhotic patients,” stated the researchers. The reported 24-week results represent interim data, as Hep C treatment can last up to 48 weeks. Researchers are following the participants to see whether these virological responses will be maintained until 12 to 24 weeks after treatment, the standard definition of a cure for Hep C. Relapse can occur before or after the end of treatment. (aidsmap.com, July 2013, in English)
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