- Response to HCV direct-acting antivirals (DAA) is favorable among patients with recent drug use (including injectable drug use [IDU]) or receiving opioid substitution therapy (OST).
Why this matters
- Some countries still restrict reimbursement based on drug use.
- Clinicians often have concerns regarding adherence and response.
- Meta-analysis of 38 studies (n=3634).
- Recent drug use often defined as within past 6 months, or at beginning/during DAA therapy.
- Efficacy endpoint was intent-to-treat rate of sustained virologic response at 12 weeks post-therapy (SVR12).
- Funding: Kirby Institute, UNSW Sydney, National Health and Medical Research Council of Australia.
- Recent drug use (injecting/noninjecting; 21 studies, n=1408): treatment completion rate was 97.5% (95% CI, 96.6%-98.3%), SVR12 was 87.7% (95% CI, 84.2%-91.3%).
- OST (36 studies, n=2987) completion rate was 97.4% (95% CI, 96.5%-98.3%) and SVR12 was 90.7% (95% CI, 88.5%-93.0%).
- Recent IDU (8 studies, n=670): completion rate was 96.9% (95% CI, 95.6%-98.2%) and SVR12 was 87.4% (95% CI, 82.0%-92.8%).
- Factors associated with SVR12 included clinical trial participation (aOR=2.18; P=.006) and higher mean/median age (aOR=1.07; P=.008).
- Clinical trials and higher mean/median age were associated with less loss to follow-up (aOR=0.45 [P=.0033] and aOR=0.94 [P=.034], respectively).
- Self-reported injecting drug use.
- Impact of adherence interventions not captured.