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Concurrent Initiation of Hepatitis C and Opioid Use Disorder Treatment in People Who Inject Drugs.
Rosenthal, Elana S; Silk, Rachel; Mathur, Poonam; Gross, Chloe; Eyasu, Rahwa; Nussdorf, Laura; Hill, Kristi; Brokus, Christopher; D'Amore, Aaron; Sidique, Nadeera; Bijole, Phyllis; Jones, Miriam; Kier, Randy; McCullough, Dana; Sternberg, David; Stafford, Kristen; Sun, Junfeng; Masur, Henry; Kottilil, Shyamasundaran; Kattakuzhy, Sarah.
Afiliación
  • Rosenthal ES; Institute of Human Virology at the University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Silk R; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Mathur P; Institute of Human Virology at the University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Gross C; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Eyasu R; Institute of Human Virology at the University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Nussdorf L; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Hill K; Institute of Human Virology at the University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Brokus C; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • D'Amore A; Institute of Human Virology at the University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Sidique N; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Bijole P; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Jones M; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA.
  • Kier R; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • McCullough D; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA.
  • Sternberg D; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Stafford K; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA.
  • Sun J; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Masur H; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA.
  • Kottilil S; DC Partnership for HIV/AIDS Progress, Hepatitis Clinical Research Program, Washington, DC, USA.
  • Kattakuzhy S; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA.
Clin Infect Dis ; 71(7): 1715-1722, 2020 10 23.
Article en En | MEDLINE | ID: mdl-32009165
BACKGROUND: People who inject drugs have a high prevalence of hepatitis C virus (HCV) and significant disease associated with drug use; however, HCV treatment often occurs in absence of interventions to address opioid use disorder and drug use-related harms. The impact of concurrent initiation of opioid agonist therapy (OAT) on HCV treatment and drug use outcomes is unknown. METHODS: In this prospective, open-label, observational trial at a harm reduction organization's drop-in center in Washington, DC, 100 patients with chronic HCV infection, opioid use disorder, and ongoing injection drug use were treated with sofosbuvir-velpatasvir for 12-weeks and offered buprenorphine initiation. The primary end point was sustained virologic response (SVR), and secondary end points included uptake of and retention in OAT, change in risk behavior, and determinants of SVR. RESULTS: Eighty-two patients (82%) achieved SVR, which was not associated with baseline OAT status (P = .33), on-treatment drug use (P >.99), or imperfect daily adherence (P = .35) but was significantly associated with completing 2 or more 28-pill bottles of sofosbuvir-velpatasvir (P < .001) and receiving OAT at week 24 (P = .01). Of 67 patients not already receiving OAT at baseline, 53 (79%) started OAT. At week 24, 68 (68%) patients were receiving OAT. Receipt of OAT was associated with fewer opiate-positive urine drug screens (P = .003), lower human immunodeficiency virus risk-taking behavior scores (P < .001), and lower rates of opioid overdose (P = .04). CONCLUSIONS: The Novel Model of Hepatitis C Treatment as an Anchor to Prevent HIV, Initiate Opioid Agonist Therapy, and Reduce Risky Behavior study demonstrates high uptake of buprenorphine collocated with HCV treatment, and it shows that concurrent initiation of OAT with HCV treatment can result in high rates of SVR while reducing risks associated with drug use. CLINICAL TRIALS REGISTRATION: NCT03221309.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preparaciones Farmacéuticas / Abuso de Sustancias por Vía Intravenosa / Hepatitis C / Trastornos Relacionados con Opioides Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preparaciones Farmacéuticas / Abuso de Sustancias por Vía Intravenosa / Hepatitis C / Trastornos Relacionados con Opioides Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos