In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey
Figen Sarigul Yildirim, Ulku User, Nefise Oztoprak, Nagehan Didem Sari, Gulsen Yoruk, B. Kurtaran, Yusuf Onlen, Suheyta Komur, Ebubekir Senates, Tayibe Bal, Alper Gunduz, Esra Zerdali, Hasan Karsen, A. Batirel, Ridvan Karaali, R. Guner, T. Yamazhan, Sukran Kose, Nurettin Erben, S. Tosun, Nevin Koc Ince, Iftihar Koksal, Sibel Kaya, I. Bozkurt, Ozgur Gunal, Ilknur Esen Yildiz, Dilara Inan, Sener Barut, Fehmi Tabak, M. Namiduru, K. Turker, Alper Sener, Kenan Hizel, Nurcan Baykam, F. Duygu, Hurrem Bodur, Guray Can, Hanefi Cem Gul, Ayse Sagmak Tartar, G Çelebi, Mahmut Sunnetcioglu, Oguz Karabay, Hayat Kumbasar Karaosmanoglu, Fatma Sirmatel
article (Uluslararası, Hakemli) | Yazar(lar): Figen Sarigul Yildirim, Ulku User, Nefise Oztoprak, Nagehan Didem Sari, Gulsen Yoruk, B. Kurtaran, Yusuf Onlen, Suheyta Komur, Ebubekir Senates, Tayibe Bal, Alper Gunduz, Esra Zerdali, Hasan Karsen, A. Batirel, Ridvan Karaali, R. Guner, T. Yamazhan, Sukran Kose, Nurettin Er
Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting.
Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed.
Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naive patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%).
Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.