Researchers have identified several factors that could facilitate treatment adherence for patients infected with hepatitis C virus (HCV) who are also people who inject drugs (PWID). Their findings are described in a paper by Zachary Rich, a medical student, of the UNC Project China at the Guangdong Provincial Dermatovenerology Hospital in Guangdong Province, and colleagues, which was published in BMC Public Health on September 20, 2016.
Direct acting antiviral (DAA) drugs are changing the way that HCV infection is treated around the world.
However, for DAAs to be effective, a high level of adherence is required. The researchers say, “Given the disproportionately high burden of disease among PWIDs, it is imperative that they are included in DAA scale-up programs and achieve high levels of adherence.” They add, “The purpose of this systematic review is to evaluate qualitative studies investigating facilitators to HCV treatment adherence among PWID.”
When Gilead’s Sovaldi was launched in late 2013, the Centers for Disease Control and Prevention (CDC) had just published new guidelines recommending everyone born between 1945 and 1965 should be tested for hepatitis C (HCV). The guidance was based on statistics showing that 75% of all HCV-infected individuals in the US fell into that cohort.
However, within the last two and a half years, treatments from Gilead, Merck, and AbbVie have shifted the treatment landscape, offering ‘cure’ rates of over 90%. With this success, the focus has shifted beyond baby boomers towards new, untreated populations.
A recent report in the National Academies of Sciences, Engineering and Medicine highlighted this fact. “Although most existing cases of HCV infections are currently in the baby boomer population, most new infections are associated with unsafe injection drug use,” the report said. Curing infected injection drug users could do much to reduce transmission, but reaching this population presents a number of challenges.