Direct‐acting antiviral interactions with opioids, alcohol or illicit drugs of abuse in HCV‐infected patients

Lorenzini, Kuntheavy Ing; Girardin, François

doi:10.1111/liv.14283

Cited by 21 publications

(20 citation statements)

References 93 publications

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“…1,22 Furthermore, drug-drug interactions between opioids, illicit substances or psychotropic medication and DAA regimens are limited, making DAA regimens suitable for treating this population. 23 In Switzerland, disease elimination models suggest that 1,500 patients need to be diagnosed annually, beginning in 2020, if Global Health Sector Strategy targets are to be achieved. 24 With 60,378 individuals treated as inpatients for mental illness in Switzerland annually and an estimated HCV prevalence of 10.8%, diagnosing and treating the 6,521 HCV-infected PMI using psychiatric hospitals and outpatient units would have a key role in meeting this target.…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis C prevalences in the psychiatric setting: Cost-effectiveness of scaling-up screening and direct-acting antiviral therapy

et al. 2021

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Screening all psychiatry admissions for HCV was cost-effective vs. standard-of-care.Generalised HCV screening enabled 917 extra patients to be treated per year.Scaling-up HCV testing to all psychiatry admissions would support HCV elimination. Lay summaryPatients hospitalised because of mental illness often have risk factors for HCV. We found that testing all psychiatry patients in hospital for HCV was costeffective compared with testing only patients who have a history of substance misuse. Scaling up HCV testing and treatment could help to wipe out HCV.

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Section: Discussionmentioning

confidence: 99%

“…1 , 22 Furthermore, drug–drug interactions between opioids, illicit substances or psychotropic medication and DAA regimens are limited, making DAA regimens suitable for treating this population. 23 …”

Section: Discussionmentioning

confidence: 99%

Hepatitis C prevalences in the psychiatric setting: Cost-effectiveness of scaling-up screening and direct-acting antiviral therapy

et al. 2021

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“…In the ITT analysis, the SVR12 rate was 95% among people without a history of injecting drug use, 92% among PWID not receiving OAT [ 47 ]. A major issue with antiviral therapy for drug users is poor compliance [ 7 ]. The pooled SVR12 rates for drug users was lower than that of LDV/SOF-treated children (99%, 95% CI 94–100) [ 48 ], adolescents (98%, 95% CI 93–100) [ 49 ] and subjects aged 65 years or older (97%, 95% CI 96–98) [ 50 ] who were not drug users.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, even a considerable burden of HCV infection does not prevent drug use among the long-term abusers [ 6 ]. The HCV load is significantly increased in people who inject drugs (PWID), and drug use accounts for 23% of the newly identified infections [ 2 , 7 ]. Furthermore, prolonged drug use in the absence of suitable interventions can significantly increase the risk of HCV infection [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of ledipasvir/sofosbuvir for hepatitis C among drug users: a systematic review and meta-analysis

Yang¹,

Tang²,

Xu³

et al. 2021

Virol J

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Background and aims Limited data is available on the efficacy of direct acting anti-viral drugs on hepatitis C in drug users. The aim of this meta-analysis was to comprehensively analyze the efficacy and safety of LDV/SOF in drug users infected with the hepatitis C virus (HCV). Methods The PubMed, Cochrane library, Embase and Web of Science databases were searched for articles published till April 2021 on HCV-positive drug users who were treated with ledipasvir/sofosbuvir (LDV/SOF). The primary endpoint was pooled sustained virological response at 12 weeks (SVR12) with 95% confidence interval (95% CI). Funnel plots and Egger’s test were used to assess the publication bias. Results A total of 12 studies and 711 subjects treated with LDV/SOF-based regimen for HCV were included, and the pooled SVR12 rate was 89.8% (95% CI 85.9–92.7). The pooled SVR12 rate of genotype 1 drug users was 92.4% (95% CI 88.6–95.0). Subgroup analysis showed that pooled SVR12 rates of patients treated with LDV/SOF and LDV/SOF ± RBV were 89.2% (95% CI 83.4–93.1), 90.4% (95% CI 83.6–94.5) respectively. In addition, the SVR12 rates were 88% (95% CI 70.7–95.7) for 8 weeks, 89.9% (95% CI 81.0–94.9) for 12 weeks and 82.2% (95% CI 24.9–98.5) for 24 weeks of treatment. Conclusion LDV/SOF is a safe and relatively effective treatment for hepatitis C in drug users.

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“…Moreover, for females of childbearing age, the use of ethinylestradiol-containing contraceptives, contraindicated in combination with GLE/PIB, may be underestimated in our cohort since these are usually not reimbursed by the statutory health insurance and are therefore mainly issued on private prescription. However, although drug abuse presents a considerable health issue and psychosocial burden, the pharmacokinetics of most illicit drugs have no or hardly any interaction potential with OST (methadone and buprenorphine) or HCV antivirals, as shown in a recent large literature review [ 18 ]. Neither efficacy nor safety was expected to suffer with a concomitant use of opioids, stimulants or cannabinoids.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy Profiles in People with Opioid Use Disorders: Considerations for Relevant Drug–Drug Interactions with Antiviral Treatments for Hepatitis C

et al. 2021

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People who inject drugs (PWID) are often affected by physical and psychological diseases and prone to co-medication. In Germany, about 50% of PWID are on opioid substitution therapy (OST). Comprehensive data on pharmacotherapy in these patients may help to select antiviral therapy against hepatitis C virus (HCV) infections and avoid drug–drug interactions (DDIs). We compared co-medication profiles based on statutory health insurance prescriptions (IQVIA database) of PWID (n = 16,693), OST (n = 95,023) and treated HCV patients (n = 7886). Potential DDIs with the most widely used HCV direct-acting agents (Sofosbuvir/Velpatasvir, Glecaprevir/Pibrentasvir and Elbasvir/Grazoprevir) were evaluated based on the Liverpool DDI database. Co-medication was present in 57% of PWID, 57% of OST, 44% of patients on HCV therapy and 46% in a subgroup receiving OST+HCV therapy (n = 747 of 1613). For all groups, co-medication belonging to ATC-class N (nervous system) was most commonly prescribed (in 75%, 68%, 41% and 62% of patients, respectively). Contraindications (i.e., DDIs precluding HCV therapy) were infrequent (0.4–2.5% of co-medications); potential DDIs with HCV therapies were shown for 13–19% of co-medications, namely for specific substances including some analgesics, antipsychotics, anticoagulants, lipid lowering drugs and steroids. In conclusion, concomitant pharmacotherapy is common and clinically relevant when treating HCV infection in PWID.

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Direct‐acting antiviral interactions with opioids, alcohol or illicit drugs of abuse in HCV‐infected patients

Cited by 21 publications

References 93 publications

Hepatitis C prevalences in the psychiatric setting: Cost-effectiveness of scaling-up screening and direct-acting antiviral therapy

Hepatitis C prevalences in the psychiatric setting: Cost-effectiveness of scaling-up screening and direct-acting antiviral therapy

Efficacy and safety of ledipasvir/sofosbuvir for hepatitis C among drug users: a systematic review and meta-analysis

Pharmacotherapy Profiles in People with Opioid Use Disorders: Considerations for Relevant Drug–Drug Interactions with Antiviral Treatments for Hepatitis C

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