Improving Quality and Scaling Up Access to HCV Treatment for the Most-At-Risk Populations within Resource Limited Settings of Ukraine


Author: Filippovych S, Burgay O, Barnard T

Theme: Clinical Research Year: 2015

Introduction:
In 2013, Alliance has introduced a peg-interferon based treatment for HIV/HCV co –infected OST patients. Overall more than 130 patients received access to HCV treatment. Introducing the pilot project of the first peg-interferon HCV treatment in Ukraine revealed the demand for scale up and introducing more effective treatment regimens.
Methods:
The study of HCV treatment efficiency with peg-interferon based regimen was conducted. Medical data on 112 HIV/HCV positive OST patients was collected during November-December 2014 by using a developed form.
Results:
The treatment period for the majority of patients who successfully completed a treatment was 48 weeks (54%), and 27% had 28 weeks treatment duration. Some of the patients had 52 and 72 weeks treatment courses. Most of the patients (53%) were with genotype 3, genotype 1 – 46%, genotype 2 – 1%. 44% of all patients who participated in the study has dropped out from the therapy. The most critical for drop-outs was 12 and 25-26 weeks of treatment. Adverse reactions (56%) such as fatigue, weight loss, insomnia, depression and absence of response to treatment (33%) were the main reasons for drop-outs.
Conclusion:
Treatment duration and adverse reactions are the most important factors which should be considered in planning HCV treatment program as factors which influence on the treatment outcomes. Psychosocial support needs to be organized on a community-based level. Shorter treatment regimens with combination DAAs was launched within the new pilot HCV treatment project in Ukraine aimed to scale up access for 1,500 HIV/HCV co-infected PWIDs

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