Theme: Clinical Research Year: 2019
Microelimination projects among PWIDs seem to be the key to HCV elimination worldwide.
We present data from a Network which connects Detoxification and Substitution Programs
with an expertized Hepatology Clinic, in Northen Greece.
We included active or ex- intravenous drug users, followed in detoxification or substitution
programs. The clinic is operated weekly in a major hospital by an addictonist from the
National Substitution Organization against Drugs (OKANA), under the umbrella of the clinic’s
hepatologist. The appointments are arranged between the programs managers and the
addictionist, after telephone contact. Patients are often accompanied by the detoxification
supervisor. All patients were treated with DAAs, according to the Greek National Guidelines
for HCV treatment.
347 patients, [308/347 males (88.76%), age 43years (79±10)] were included. 288/347
(82.293%) were HCV RNA (+). HCV genotype distribution was 1α:18.40%, 1b:11.11%,
2:4.86%, 3α:57.29%, 4:8.33%.198/288 (68.75%) were receiving substitution therapy
[buprenorphine:162/288 (56,25%), methadone:36/288 (12.50%)], 61/288 (21.18%) were in
other detoxification programs without substitution treatment and 29/288 (10.07%) were not
participating in any program. 238/288 (82.64%) initiated treatment with DAAs. The DAA
regimens were sofosbuvir/velpatasvir: 42.18%, sofosbuvir/velpatasvir+ribavirin: 6.3%,
sofosbuvir/ledipasvir: 7.14%, sofosbuvir/ledipasvir+ribavirin:0.84%,
glecaprevir+pibrentasvir:16.13%.175/238 (73.5%) completed therapy, 50/238 (21.01%) are
still on treatment and 13/238 (5.46%) discontinued prematurely. SVR12 rate for the first
121/175 patients who completed post-treatment follow-up was 98.35% (119/121). 16/175
(9.14%), although expected, have not yet been examined for SVR. 63/288 patients (21.88%)
were lost to follow up: 50/288 (17.36%) did not initiate DAAs treatment due to illness,
imprisonment, long distance from hospital, other priorities or indifference and 13/288
(4.51%) discontinued treatment.
Network connections between Detoxification and Substitution Programs with expertized
hepatology clinics, under the collaboration of hepatologists and addictionists, show excellent
efficacy and high compliance in PWIDs Treatment of hepatitis C with DAAs.
Disclosure of Interest Statement: Nothing to disclose