Heroin Assisted Treatment Setting: Feasibility and Efficacy of Hepatitis C DAA Treatment

Author: Brunner N, Graf S, Bruggmann P

Theme: Clinical Research Year: 2016


Brunner N¹, Graf S¹, Bruggmann P¹

¹Aurd centres for addiction medicine, Zurich, Switzerland

Background: Heroin assisted treatment (HAT) is an established harm reduction measure in Switzerland since 1994. Heroin is provided for patients on daily base as injection or tablet. This setting is highly eligible for additional treatments requiring high levels of adherence like Hepatitis C (HCV) direct antiviral acting (DAA) medication in people who inject drugs (PWID). Arud provides comprehensive addiction therapy in an all-under-one-roof setting, including HAT.

Methods: Retrospective analysis of HCV DAA treatment in HAT patients at Arud centres for addiction medicine in Zurich between January 2015 and April 2016.

Results: 12 HAT patients have been treated with DAAs. 8 patients used heroin intravenously (75%), 4 used heroin orally (25%). 42% (n=5) of the patients were female, the mean age was 45 years (24-63), 17% (n=2) were co-infected with HIV. 50% (n=6) had genotype 1a, 17% (n=2) genotype 1b, 8% (n=1) genotype 3, 25% (n=3) genotype 4. 7 (58%) of the patient had liver cirrhosis, 6 of them Child Pugh A, 1 Patient Child Pugh B. In 7 of the cases (58%) Sofosbuvir/Ledipasvir was the DAA-combination for treatment, 3 (25%) were treated with Ombitasvir, Paritaprevir, Dasabuvir and Ritonavir, and 1 (8%) each with Daclatasvir plus Sofosbuvir and with Sofosbuvir plus Simeprevir. All patients (100%) achieved SVR 12.

Conclusion: Recent studies have shown comparable DAA treatment outcome among OST patients as in general population. HAT builds an additional harm reduction measure for patients failing with OST. This study shows feasibility and high efficacy of HCV DAA treatment in the setting of HAT.

Disclosure: nothing to disclose

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