New and Noteworthy
People who inject drugs should have access to hepatitis C treatment, expert panel recommends
New guidelines for the management of Hep C in people who inject drugs encourage offering treatment to people who inject drugs, reported researchers in the International Journal of Harm Reduction Policy.
The recommendations were developed by an international expert panel organized by the International Network for Hepatitis in Substance Users.
The guidelines are designed to address a series of barriers to Hep C treatment for people who inject drugs, in particular the perception that people who are using drugs cannot adhere to antiviral treatment.
The recommendations state that a history of injection drug use or recent use is not associated with a lower chance of having a sustained virological response (SVR) or being cured from Hep C treatment. The decision to treat people who inject drugs should be made on a case by case basis.
The guidelines recognize that for many people who currently or used to inject drugs, housing, social support, finances and mental health pose significant barriers to engagement with medical care and adherence to treatment. Addressing these issues is recommended as part of the pre-treatment assessment.
The recommendations also state that the perceived risk of reinfection should not be considered grounds to deny treatment to people who inject drugs. (aidsmap.com, October 2015, in English)
Halifax researcher starts Hep C treatment study in a PEI prison
Approximately 60 prisoners in PEI will be treated with Holkira Pak over the next year as part of a study led by the Nova Scotia Health Authority. This study will follow participants after treatment is over in order to examine any changes to the immune system. The Health Authority also plans to launch a multi-site study in corrections facilities in all four Atlantic Provinces.
Holkira Pak will be provided to all Hep C –positive prisoners at the PEI provincial correctional centre who have genotype 1 virus and agree to participate. The participants will be followed for one year after treatment, either in the prison or community.
According to the researchers, “Beyond providing effective treatment, this study will help us assess the feasibility of treating hepatitis C in corrections settings, while shedding light on the new drugs’ potential to protect against re-infection.” (cbc.ca, in English, October 2015)
Opioid substitution therapy use does not impact cure rate in people taking Harvoni
Cure rates in people taking Harvoni who were on opioid substitution therapy (OST) were similar to those in people not taking OST, reported researchers at the 4th International Symposium on Hepatitis in Substance Users.
The late-stage clinical trial data set was composed of 1952 participant, of whom 70 were taking OST.
Participants took Harvoni with or without ribavirin for eight, 12 or 24 weeks.
The cure rates for people taking OST were 94% compared to 97% of people not taking OST.
The percentage of participants who were considered adherent to treatment was similar in people taking OST compared to those who were not (94% vs. 96%). The proportion of adverse events or side effects was also similar (89% vs. 80%).
There were no cases of re-infection 24 weeks after treatment.
“The interferon-free, once-daily, single tablet regimen of Harvoni achieved high and comparable SVR12 among people with Hep C genotype 1 regardless of OST use”, concluded the researchers. (natap.org, October 2015, in English)