The eradicate-C study-curing people who are actively injecting drugs of hepatitis C: The first step to elimination
Author(s): ,
Linda Johnston
Affiliations:
gastroenterology,University of Dundee,Dundee,United Kingdom
,
Farsana Ahmad
Affiliations:
gastroenterology,NHS Tayside,Dundee,United Kingdom
,
Brian Stephens
Affiliations:
gastroenterology,NHS Tayside,Dundee,United Kingdom
John F Dillon
Affiliations:
gastroenterology,University of Dundee,Dundee,United Kingdom
EASL LiverTree™. Ahmad F. Apr 20, 2017; 168730; THU-278 Topic: Viral hepatitis
Ms. Farsana Ahmad
Ms. Farsana Ahmad
Contributions
Abstract

THU-278

Topic: Viral hepatitis: Hepatitis C - Clinical (therapy)

Background and aims
More than 85% of hepatitis C virus (HCV) diagnoses in Scotland are in people who inject drugs (PWID), those still actively injecting can be deemed too chaotic to treat. However if “treatment as prevention” (TasP) is to work active PWIDs must be treated. The Eradicate study seeks out active PWID with HCV and offers them treatment, to prove that it is possible to deliver cure to the target population for TasP. 

Methods
To identify and recruit 100 active PWIDs over a five-year period, who are HCV positive and actively injecting, through needle exchange centres in Tayside. Genotype 1 (GT1) treated with a protease inhibitor (Telaprevir or Simeprevir) plus Peglyated Interferon and Ribavirin. Genotype 2 (GT2) and 3 (GT3) treated with Pegylated Interferon and Ribavirin. Patients were seen and treated in a needle exchange on a weekly basis.

Results
A total of 105 patients were recruited in 42 months, 72% were male, and of these 94 patients went on to receive treatment. Of these 94 patients 40.4% were GT1, 1.1% GT2 and 58.5% GT3. Eleven patients did not commence treatment as 3 spontaneously resolved, 4 were lost to follow up, 2 were treated on standard pathway as they became drug free, 1 died prior to commencing treatment and 1 was in prison out-with the catchment area.

Of the 94 patients who received treatment, 89 SVR 12 results are available, 74/89 (83.1%) have achieved SVR. Of the 15 patients who did not achieve SVR12, 14 relapsed on treatment (only 4 of these patients completed the entire treatment, 7 completed less than half of the allotted treatment) and 1 became re-infected with a different genotype.

The rate of re-infection is 1 per 9 patient- years.

Conclusions
Active PWID can be successfully treated and cured of HCV, with SVR 12 rates of 83.1% on DAA/Pegylated Interferon and Ribavirin treatment regimes. The re-infection rate is compatible with a treatment as prevention strategy.

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