Treating Hepatitis C-Infected Injection Drug Users

Treating Hepatitis C-Infected Injection Drug Users

Hepatitis C virus (HCV) leads to more than 15,000 deaths annually in the U.S. Antiviral drugs capable of curing HCV infection were introduced several years ago. Yet people who inject drugs—who are at the heart of the country’s HCV epidemic—are rarely offered anti-HCV therapy, due to concerns over poor medication adherence. In a study evaluating whether intensive treatment interventions improves adherence researchers including first author, Matthew Akiyama, M.D., M.Sc., and senior author and principal investigator Alain Litwin, M.D., M.P.H., of Clemson University and Prisma Health randomly assigned 150 HCV-positive people participating in an opioid treatment program to one of three antiviral treatment models: medication administered in directly observed therapy (DOT); medication in a group-therapy (GT) setting, or self-administered individual treatment (SIT), the control group. The findings were published online on April 9 in the Annals of Internal Medicine. High HCV cure rates were observed in all three groups: 98% for DOT patients, 94% for GT patients, and 90% for SIT patients. The findings indicate that HCV therapy should not be withheld for injection drug users, particularly those undergoing treatment for opioid use disorder.  Dr. Akiyama is an assistant professor of medicine at Einstein and attending physician in infectious diseases and in internal medicine at Montefiore.

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