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https://hdl.handle.net/2440/133241
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Type: | Journal article |
Title: | Adherence to sofosbuvir and velpatasvir among people with chronic HCV infection and recent injection drug use: the SIMPLIFY study |
Author: | Cunningham, E.B. Amin, J. Feld, J.J. Bruneau, J. Dalgard, O. Powis, J. Hellard, M. Cooper, C. Read, P. Conway, B. Dunlop, A.J. Norton, B. Litwin, A.H. Hajarizadeh, B. Thurnheer, M.C. Dillon, J.F. Weltman, M. Shaw, D. Bruggmann, P. Gane, E. et al. |
Citation: | International Journal of Drug Policy, 2018; 62:14-23 |
Publisher: | Elsevier |
Issue Date: | 2018 |
ISSN: | 0955-3959 1873-4758 |
Statement of Responsibility: | Evan B.Cunningham, Janaki Amin, Jordan J.Feld, Julie Bruneau, Olav Dalgard, Jeff Powis ... et al. |
Abstract: | BACKGROUND:This study investigated treatment adherence among people with recent injecting drug use in a study of sofosbuvir/velpatasvir therapy for HCV infection. METHODS:SIMPLIFY is an international open-label, single-arm multicentre study that recruited participants with recent injecting drug use (previous six months) and chronic HCV genotype (G) 1-6 infection between March and October 2016 in seven countries (19 sites). Participants received sofosbuvir/velpatasvir once-daily for 12 weeks administered in a one-week electronic blister pack (records the time and date of each dose) for 12 weeks. We evaluated non-adherence (<90% adherent) as measured by electronic blister-pack assessed using logistic regression and generalised estimating equations (continuous) with detailed analyses of dosing dynamics. RESULTS:Among 103 participants, 97% (n = 100) completed treatment. Median adherence to therapy was 94%. Overall, 32% (n = 33) were considered non-adherent (<90% adherence). Adherence significantly decreased over the course of therapy. Recent stimulant injecting (cocaine and/or amphetamines) at treatment initiation and during treatment was independently associated with non-adherence. Inconsistent dose timing (standard deviation of daily dose timing of ≥240 min) was also independently associated with non-adherence to therapy. Factors associated with inconsistent dose timing included lower levels of education and recent stimulant injecting. SVR was similar among adherent and non-adherent populations (94% vs. 94%, P = 0.944). CONCLUSION:This study demonstrated high adherence to once-daily sofosbuvir/velpatasvir therapy among a population of people with recent injecting drug use. Recent stimulant injecting prior to and during DAA therapy and inconsistent dose-timing during treatment was associated with non-adherence. However, there was no impact of non-adherence on response to therapy, suggesting that adherence is not a significant barrier to successful DAA therapy in people with recent injecting drug use. |
Keywords: | HCV; treatment; PWID; drug use; injecting drug users; compliance; OST; blister pack; stimulants; amphetamine; cocaine |
Rights: | © 2018 Elsevier B.V. All rights reserved. |
DOI: | 10.1016/j.drugpo.2018.08.013 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1016/j.drugpo.2018.08.013 |
Appears in Collections: | Medicine publications |
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