Theme: Clinical Research Year: 2021
Background: Retreatment occurred in 6% receiving direct-acting antivirals (DAAs) for hepatitis C virus(HCV) through Australia’s unrestricted access scheme during 2016-2019. However, retreatment reasons and outcomes, including among people who inject drugs (PWID), were unknown. Methods: Real-world effectiveness of antiviral therapy in chronic HCV (REACH-C) is an observational study representing 14% DAA initiations in Australia across 33 diverse sites between March 2016-June 2019. Retreatment data were collected until October 2020. Reinfections were documented at SVR (treated/untreated) and post-SVR (treated only). Results: Of those commencing DAAs (n=10843), 16% (n=1775) were PWID (injected drugs last six-months), 65% (n=7007) non-PWID, and 19% (n=2061) unknown-PWID. Compared to non-PWID, PWID were younger (median age 43 vs 53), male (76% vs 67%), opioid agonist recipients (44% vs 11%), and incarcerated (11% vs 5%). Per-protocol SVR for initial treatment was lower in PWID vs non-PWID (93.5% vs 95.2%; p=0.015). Among those with treatment failure, reinfection accounted for 19% (n=17/88) and 1% (n=3/302) among PWID and non-PWID. Retreatment uptake for treatment failure among PWID and non-PWID was similar (56% vs 58%). Overall, retreatment occurred more in PWID than non-PWID (7% vs 3%; p
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