Hepatitis C Treatment in Persons Who Inject Drugs in a Medication Assisted Treatment Program: A Retrospective Review of an Integrated Model

Abstract

Background: Hepatitis C virus (HCV) infection is common among persons who inject drugs (PWID), mostly due to needle sharing. The number of new cases in PWID are steadily increasing despite the availability of effective treatments. The objective of this model is to increase uptake and compliance with HCV treatment. We developed a model to treat HCV and opioid use disorder simultaneously in a methadone maintenance program. Methods: Patients were screened on site for HCV at admission and then annually. Once HCV was positive, the genotypes and fibrosis scores were identified. Patients were enrolled into the treatment program after obtaining written consent. Patients either self-administered the medications at home or utilized a directly observed treatment (DOT). The sustained virologic response (SVR) was tested at 12 weeks posttreatment. We conducted a retrospective review of patients who received treatment and reviewed the demographic data, co-infections, medication administration, and SVR results at the end of study period. Results: One hundred ninety patients were identified as Hepatitis C positive. 88.9% (169 patients) received HCV treatment during the study period. 62.7% (106 patients) were male and 37.3% were female (63 patients). 62.7% of them (106 patients) completed HCV treatment by the end of study period. Out of them, 96.2% (102 patients) achieved SVR. 68.9% (73 patients) utilized DOT for medication administration. Conclusions: Our model successfully treated HCV in our patient population, who are otherwise deprived of resources and access to health care. Replicating this model is a potential strategy to reduce the disease burden and break the transmission cycle of HCV.

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“…National versus local and general population versus high-risk population questions are priority issues. The next step is enrolling people in the intervention program for laboratory testing, treatment of the viremic patients, and follow-up [ 41 ].…”

Postpartum Treatment for Chronic Hepatitis C Virus Among People With Opioid Use Disorder: A Prospective Pilot Clinical Trial

“…Integrated models have emerged in part due to the development of DAAs, which have transformed the HCV treatment landscape due to their ease of administration, limited adverse effect profile, and ability to provide a greater than 95% cure rate after 8–12 weeks of once daily oral therapy 15,16 . As such, the effectiveness and convenience of HCV DAAs have allowed providers outside of infectious disease and gastroenterology subspecialties to deliver HCV treatment in a variety of clinical settings including substance use treatment programs 17,18 …”