High Rates of Sustained Virological Response in People Who Inject Drugs Treated With Sofosbuvir-Based Regimens in Ukraine

Author: Yeromina GI, Barnard TP, Burgay OS, Filippovych SA

Theme: Clinical Research Year: 2016


Yeromina GI1, Barnard TP1, Burgay OS1, Filippovych SA1

1 ICF “Alliance for Public Health”, Ukraine

Background: Starting from June 2015 ICF “Alliance for Public Health” (Alliance) has been implementing HCV treatment with SOVALDI-based (SOF) regimens for most-at-risk populations. As of April 1, 2016, 633 patients had access to HCV treatment. 80% (N=511) are people who inject drugs (PWIDs). 47% (N=238) completed full course of treatment, 50% (N=259) continue their treatment, 3% (N=14) discontinued.

Methods: Main treatment regimens: SOF+RBV+Peg-IFN 12W in 73% (N=373), SOF+RBV 24W in 17% (N=88), SOF+RBV 12W in 6% (N=32). Database of HCV patients has been developed; detailed medical records for all patients are collected monthly in depersonified form including demographic data; HIV status; ART, OST, HCV treatment regimens; genotype; fibrosis stage; RNA HCV W4, W12(24), 12 weeks after the EOT.

Results: As of April 1, 2016 there are 126 results of RNA HCV testing 12 weeks after the EOT. 82% (N=104) are male, G1 and G3 are prevalent (46% and 43% correspondingly), fibrosis stage in 85% of patients is ≥F2. 6% are on OST (methadone n=5, buprenorphine n=3). 12 (9%) patients did not reach SVR12 (RVR was not reached in 6 patients, EOT was not reached in 3 patients. 5 patients had RVR and EOT but have not reached SVR12 (SOF+RBV+PEG 12w; 4 of them have G1; 2 patients are Peg-IFN experienced; 1 reported case of reinfection, relapse to IDU). 115 patients (91%) of 126 reached SVR12, 22 (20%) were treatment-experienced.

Conclusion: Sofosbuvir- based HCV treatment in PWID population shows high cure rates. In G3 patients SVR 12 is higher than in G1 patients. Drop out from the treatment is low. Social and peer support of PWIDs is important for recruiting and treatment adherence. Reinfection interventions should be included as one of the obligatory activities for active PWID and strongly recommended for PWID with different period of remission including OST patients.

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