New and Noteworthy
Staying Safe Intervention reduces risk for Hep C and HIV in people who inject drugs
An evaluation of an intervention designed to prevent the transmission of Hep C and HIV among people who inject drugs has shown decreases in behaviours considered a risk for contracting Hep C and HIV.
This strengths-based intervention was created based on the results of a study that examined the strategies and behaviours of people who injected drugs for 8 to 15 years but did not contract HIV or Hep C. These strategies were then shared with intervention participants over the course of five group sessions. 51 participants completed the evaluation.
Three months after the intervention had ended, participants reported several changes, including:
- less sharing of syringes, filters, water and water containers
- fewer weekly injections
- spending less on street drugs
- improved perceptions of their ability to plan ahead to avoid injection-related risk
Also, the number of participants who provided sterile syringes to people they injected with increased.
“Given the substantial reductions observed among Staying Safe participants in key injection-related behaviours associated with Hep C transmission, the Staying Safe Intervention may have the potential to contribute to sufficient additional risk reduction to help address the seemingly intractable rates of Hep C transmission among people who inject drugs,” reported the researchers. (Healio.com, April 2014, in English)
For more information about the Staying Safe research project, see the Prevention in Focus article, “Staying safe: what people who inject drugs know about preventing Hep C and HIV.”
Three-drug combination effective for treating Hep C post-liver transplant
A three-drug combination of direct-acting anti-viral medications cured 96% of liver transplant patients with Hep C, reported researchers at the EASL International Liver Congress in London.
People with Hep C who have a liver transplant almost always develop hepatitis C in their new liver. About a quarter of these people will develop severe liver damage within five years of the transplant. Finding effective treatments for this group is a high priority.
The 34 participants in this small mid-stage trial took a combination of three drugs:
- ABT 450 boosted with ritonavir (once daily)
- ombitasvir (once daily)
- dasabuvir (twice daily)
All participants were treated for 24 weeks. The most common side effects were headache, fatigue, cough and insomnia.
People who have had an organ transplant must take medications to prevent the body from rejecting the new organ. Researchers found no significant interactions between these medications and this combination of Hep C medications.
This is a promising new treatment combination for a group that has not done well on traditional interferon-based treatments. (HIVandhepatitis.com, April 2014, in English)
Sofosbuvir (Sovaldi) and ledipasvir cures over 90% of participants in large clinical trials
In three large clinical trials, sofosbuvir (Sovaldi) and ledipasvir, combined into a single pill, with or without ribavirin cured more than 90% of participants with Hep C genotype 1 virus.
In the first trial, people who had never been treated for Hep C before were put in one of four treatment arms:
- sofosbuvir (Sovaldi) and ledipasvir for 12 weeks
- sofosbuvir (Sovaldi), ledipasvir and ribavirin for 12 weeks
- sofosbuvir (Sovaldi) and ledipasvir for 24 weeks
- sofosbuvir (Sovaldi), ledipasvir and ribavirin for 24 weeks
All trial arms had cure rates of 97%-99%. The most common side effects were headache, fatigue and nausea. A small number of participants in the ribavirin-containing arms developed anemia.
In the second trial, people who had previously been treated for Hep C but did not respond to treatment were put into four treatment arms:
- sofosbuvir (Sovaldi) and ledipasvir for 12 weeks
- sofosbuvir (Sovaldi), ledipasvir and ribavirin for 12 weeks
- sofosbuvir (Sovaldi) and ledipasvir for 24 weeks
- sofosbuvir (Sovaldi), ledipasvir and ribavirin for 24 weeks
Cure rates for these trial arms were also very high (94%-99%). Participants with severe liver damage or cirrhosis did not do as well on the 12-week treatment (86% cure rate) as on the 24-week treatment (100% cure rate).
Given the high cure rates in the first trial, a third trial was started to determine if treatment with this combination of drugs could be shortened from 12 weeks to eight weeks for people with the Hep C genotype 1 virus who had never been treated before.
Participants received one of three treatments:
- sofosbuvir (Sovaldi) and ledipasvir for eight weeks
- sofosbuvir (Sovaldi), ledipasvir and ribavirin for eight weeks
- sofosbuvir (Sovaldi) and ledipasvir for 12 weeks
All trials arms had similar cure rates (93%-95%), indicating that treatment with sofosbuvir (Sovaldi) and ledipasvir could be shortened to eight weeks and still be effective. (HIVandhepatitis.com, April 2014)