Study Backs Hepatitis C Treatment in Injection Drug Users

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Use of sofosbuvir-velpatasvir to treat hepatitis C virus (HCV) infection in injection drug users usually leads to a sustained virologic response at 12 weeks, according to an industry-supported study in the Lancet Gastroenterology & Hepatology.

Some 103 patients with chronic HCV infection (types 1–4) who reported injection drug use in the prior 6 months received sofosbuvir-velpatasvir once daily for 12 weeks. At baseline, three-quarters had injected drugs in the past month. Roughly 60% of participants were receiving opioid substitution therapy during the study.

Of 100 participants who completed treatment, 99 had an end-of-treatment response. The primary outcome — sustained virologic response 12 weeks later — occurred in 94% of all participants. Of the three participants who completed treatment but didn't achieve the primary outcome, two were lost to follow-up and one had HCV reinfection.

Commentators note that although guidelines recommend HCV treatment for drug users, "stigma ... has resulted in insurance restrictions and reluctance from providers to offer appropriate medical therapy." They conclude that HCV-infected injection drug users "can and should be treated with direct-acting antivirals."

Follow-up of this cohort is ongoing.