DOES INJECTING BEHAVIOUR CHANGE FOLLOWING DIRECT ACTING ANTIVIRAL HEPATITIS C THERAPY IN PERSONS WHO INJECT DRUGS ?


Author: Inglis SK, Byrne C, Beer LJ, Dillon JF

Theme: Clinical Research Year: 2019

Background: Advance HCV is a clinical trial treating persons who actively inject drugs (PWID) for
hepatitis c (HCV) with DAAs in injecting equipment provision sites in NHS Tayside, Scotland. The trial is
ongoing, and collects data on injection of illicit substances at baseline and end of treatment. This
information can inform whether completing HCV treatment influences injecting behaviours, and the
need for ongoing testing post-treatment.
Methods: Participants are asked: ‘When did you last inject?’ at baseline and end of treatment.
Responses are: within the last week; within the last month; within the last three months; not in the last
three months. Active injecting (within the last 3 months) is a requirement at baseline.
Results: Data are currently available for 36 randomised participants. Most (23) reported no change in
injecting frequency following HCV therapy; 8 reported decreased frequency; 5 reported increased
frequency. Of those reporting no change, 21 injected in the last week; 1 in the last month; and 1 in the
last three months. Of those who decreased post-treatment: 2 decreased from within the last week to
within the last month; 2 from within the last month to within the last three months; 4 from within the
last week to within the last three months. Of those who increased post-treatment: 3 increased from
within the last month to within the last week; 1 from within the last three months to within the last
week; 1 from within the last three months to within the last month.
Conclusion: The majority of those who have completed HCV treatment in Advance have not changed
their injecting frequency. This suggests that despite completing HCV therapy, there is an ongoing risk
behaviour which warrants continual HCV testing in PWID to monitor for re-infection post-treatment and
harm reduction interventions. This has implications for HCV elimination strategies.
Disclosure of Interest Statement: Merck Sharp Dohme are funding the study and providing Zepatier for
135 participants. SI, CB and LB declare no conflict of interest. JFD has received honoraria for lectures and
research grants from Janssen, Roche, MSD, AbbVie, Bristol-Myers Squibb and Gilead.

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