Chronic Hepatitis C, People Who Inject Drugs
Conditions
Brief summary
Direct antiviral therapy (standard of care) administered to chronic hepatitis C-infected patients, in two hepatology clinics, who had used intravenous drugs in the past 6 months of signing informed consent (IC). This cohort was compared to concurrently treated chronic hepatitis C patients who were not intravenous drug users, who signed IC in these same clinics. Follow-up expected two years after cure and relapse rates recorded. Primary end point was SVR rate and secondary end points included reinfection rates in follow-up period.
Detailed description
Chronically HCV-infected participants were recruited and treated at two liver referral clinics in Georgia, but had been referred from opioid substitution therapy clinics, primary care and GI clinics, neighboring hospitals, and correctional centers. Once consented, a nurse navigator was assigned to each participant was responsible for all subjects' appointments, and med supplies. Drug testing was mandated at specified intervals. Patients with recent injection drug use (within 6 months) were assigned to the PWID (people who inject drugs) arm, and those who hadn't injected within 6 months, but agreed to be in the study and signed consents, were assigned to the non-PWID arm. Both groups were treated with velpatasvir (100 mg) and sofosbuvir (400 mg) once daily for 12 weeks (brand or branded generic). Adherence was assessed by pill counts. Mandatory treatment visits were scheduled for baseline, 4 and 12 weeks (+/- 2 weeks) and follow-up (FU) week 12 (+ 4 months). Long-term FU was flexible and could be virtual, but was mandated once yearly with HCV RNA testing.
Interventions
DRUGvelpatasvir and sofosbuvir once daily for 12 weeks (brand or branded generic) .
Directly active antiviral therapy (velpatasvir 100 mg+sofobuvir 400 mg) once daily
Sponsors
Center For Hepatitis C, Atlanta, GA
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
PWID arm and non-PWID arm prospective, parallel observational cohorts
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Chronic HCV infection and PWID arm: use of intravenous drug use at least once in preceding six months. In Non-PWID arm: no use of intravenous drug use at least once in preceding six months.
Exclusion criteria
* Co-infection with chronic hepatitis B; Decompensated cirrhosis current or by history; inability to sign informed consent; unwilling to take therapy or unable to obtain therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sustained Virologic Response | 24 weeks after medication initiation | Undetectable HCV RNA 12 weeks after completion of antiviral therapy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reinfection rate hepatitis C | in follow-up period (expected 2-3 years) | Detection of HCV RNA in follow-up period after SVR has been obtained |
| Intravenous drug use | informed consent through end of follow-up (up to 3 years) | rate of IV drug use compared between baseline and end of follow-up |
| Opioid Substitution Therapy (OST) | informed consent through end of follow-up (up to 3 years) | rate of OST compared between baseline and end of follow-up |
Countries
United States
Outcome results
None listed