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Carla Treloar - One of the best experts on this subject based on the ideXlab platform.

  • beyond interferon side effeCts what residual barriers exist to daa Hepatitis C Treatment for people who injeCt drugs
    PLOS ONE, 2018
    Co-Authors: Annie Madden, Max Hopwood, Joanne Neale, Carla Treloar
    Abstract:

    ReCent advanCes in the effiCaCy and tolerability of Hepatitis C Treatments and the introduCtion of a universal aCCess sCheme for the new DireCt ACting Antiviral (DAA) therapies in MarCh 2016, has resulted in a rapid inCrease in the uptake of Hepatitis C Treatment in Australia. Despite these positive developments, reCent data suggest a plateauing of Treatment numbers, indiCating that more work may need to be done to identify and address ongoing barriers to Hepatitis C Treatment aCCess and uptake. This paper aims to Contribute to our understanding of the ongoing barriers to DAA therapies, with a foCus on people who injeCt drugs. The paper draws on partiCipant interview data from a qualitative researCh study based on a partiCipatory researCh design that inCluded a peer researCher with direCt experienCe of both Hepatitis C DAA Treatment and injeCting drug use at all stages of the researCh proCess. The study’s findings show that residual barriers to DAA Treatment exist at personal, provider and system levels and inClude poor venous aCCess, DAA Treatments not Considered ‘Core-business’ by opioid substitution Treatment (OST) providers, and patients having to manage multiple health and soCial priorities that interfere with keeping mediCal appointments suCh as ChildCare and poor aCCess to transport serviCes. Further, efforts to inCrease aCCess to and uptake of DAA Hepatitis C Treatment over time will require a foCus on reduCing stigma and disCrimination towards people who injeCt drugs as this remains as a major barrier to Care for many people.

  • not just methadone traCy transformations in serviCe user identity following the introduCtion of Hepatitis C Treatment into australian opiate substitution settings
    Addiction, 2014
    Co-Authors: Jake Rance, Carla Treloar
    Abstract:

    Aims To explore identity transformation among serviCe users attending opiate substitution therapy (OST) CliniCs following the introduCtion of Hepatitis C (HCV) Care and Treatment. Design An interview-based substudy of the Australian ETHOS (EnhanCing Treatment for Hepatitis C in Opiate Substitution Settings) projeCt. Setting Three OST CliniCs and one Community health Centre (operating a publiC OST) in New South Wales, Australia. PartiCipants were interviewed at the reCruitment sites. PartiCipants The sample Consisted of 57 OST serviCe users ConCurrently living with HCV, 16 staff, inCluding speCialist HCV CliniCians, and three peer-support workers, employed on the ETHOS projeCt. Measurements Semi-struCtured interviews. Findings ServiCe-user partiCipants largely welComed the introduCtion of HCV Treatment as a praCtiCal, CliniCal intervention that also intimated a more Comprehensive, holistiC form of Care. Negative stereotypes CharaCteristiC of OST settings—of limited, routinized CliniCal exChanges and minimal soCial-Care interaCtion—were unsettled, opening up the possibility of new relations between staff and serviCe users. The shift in the dynamiC of the CliniCal enCounter to address health in addition to dependenCe appeared to Catalyse transformative possibilities not only for the therapeutiC allianCe but also for serviCe-user understandings of self and identity. ConClusion Trial introduCtion of HCV Care and Treatment in seleCted Australian opiate substitution therapy (OST) CliniCs may have faCilitated alternative, ‘non-addiCt’ identities to emerge from a CliniCal setting where the stigmatizing figure of ‘the drug user’ has traditionally prevailed.

  • the politiCs of plaCe ment problematising the provision of Hepatitis C Treatment within opiate substitution CliniCs
    Social Science & Medicine, 2012
    Co-Authors: Jake Rance, Max Hopwood, Jamee Newland, Carla Treloar
    Abstract:

    The Hepatitis C virus (HCV) epidemiC is a signifiCant publiC health Challenge in Australia. Current initiatives to expand aCCess to HCV Treatment foCus on opiate substitution therapy (OST) settings where the prevalenCe of Hepatitis C among Clients is high. In Australia, the provision of OST for many Clients is via large CliniCs, with an estimated median of 150 Clients per serviCe. ConCeptually informed by the work of MiChel FouCault, our analysis of the proposed integrated Treatment model foCuses on the CritiCal but overlooked question of organisational Culture and power operating within OST. We argue that the speCifiC Context of OST not merely refleCts but aCtively partiCipates in the politiCal eConomy of soCial exClusion via whiCh the soCio-spatial segregation and stigmatisation of the serviCe user as ‘drug user’ is enaCted. This paper analyses data ColleCted from two samples during 2008/9: OST Clients living in New South Wales, Australia and a range of OST health professionals working in Australian settings. In total, 27 interviews were ConduCted with Current OST Clients; 19 by phone and 8 faCe-to-faCe. One foCus group and 16 telephone interviews were ConduCted with OST health professionals. Our analysis of key themes emerging from the interview data suggests that the suCCessful introduCtion of HCV Treatment within the OST CliniC is not a given. We are ConCerned that partiCular areas of tension, if not expliCit ContradiCtion, have been overlooked in Current researCh and debates informing the proposed Combination Treatment model. We question the appropriateness of Co-loCating a notoriously arduous, exaCting Treatment (HCV) within the highly surveillant and regulatory environment of OST. While applauding the intention to improve aCCess to HCV Care and Treatment for people who injeCt drugs we Caution against a Treatment model that risks further entrenChing (soCio-spatial) stigmatisation amongst those already experienCing signifiCant marginalisation.

  • faCtors assoCiated with Hepatitis C knowledge among a sample of Treatment naive people who injeCt drugs
    Drug and Alcohol Dependence, 2011
    Co-Authors: Carla Treloar, Max Hopwood, Peter Hull, Joanne Bryant, Jason Grebely, Yvonna Lavis
    Abstract:

    AbstraCt BaCkground Assessment and uptake of Treatment for Hepatitis C among people who injeCt drugs (PWID) is low and strategies to enhanCe Hepatitis C Care in this group are needed. Knowledge of Hepatitis C and its Treatment is one preCursor to deCisions about Treatment. Methods We ConduCted a Cross-seCtion study designed to evaluate Treatment Considerations in partiCipants with self-reported Hepatitis C infeCtion in New South Wales, Australia. PartiCipants were reCruited from needle and syringe programs, opiate substitution CliniCs, pharmaCies that dispensed opiate substitution Treatment and from the mailing list of a Community-based Hepatitis C organisation and Completed a self-administered survey. Knowledge of Hepatitis C was assessed by a 48-item sCale addressing the natural history and Treatment of Hepatitis C. FaCtors assoCiated with knowledge were assessed by ordinal regression. Results Among the 997 partiCipants reCruited, 407 self-reported aCquiring Hepatitis C through injeCting drug use and had never reCeived Hepatitis C Treatment. Knowledge about Hepatitis C was overall poor and the effeCts of the long term ConsequenCes of Hepatitis C were over-estimated. Higher knowledge sCores were assoCiated with reCruitment site, higher eduCation levels and reCent ContaCt with a general praCtitioner. One-third of partiCipants indiCated that they did not intend to have Treatment and one-fifth did not answer this question. ConClusion Knowledge is a preCursor to informed deCisions about Hepatitis C Treatment. These results indiCate that efforts to support those less engaged with Hepatitis C Care (and speCifiCally those on opiate substitution Treatment) and those with lower literaCy are required.

  • resilient Coping applying adaptive responses to prior adversity during Treatment for Hepatitis C infeCtion
    Journal of Health Psychology, 2008
    Co-Authors: Max Hopwood, Carla Treloar
    Abstract:

    SoCial marginalization is assoCiated with poor health outComes for affeCted people. However, in a psyChosoCial study of Treatment for Hepatitis C infeCtion ConduCted in Sydney, Australia, partiCipants living in soCially disadvantaged CirCumstanCes applied adaptive approaChes learned from past experienCes of drug dependenCe, living with symptoms of ChroniC illness, Coping with depression and Childhood sexual abuse to enable them to Cope with severe Treatment-related side-effeCts. This finding has impliCations for the CliniCal management of Hepatitis C Treatment; the faCtors and proCesses that faCilitate adaptive Coping to adversity assoCiated with soCial marginalization Can be assessed for their CliniCal Contribution to Coping with an arduous regimen.

Gregory J Dore - One of the best experts on this subject based on the ideXlab platform.

  • demonstration of near elimination of Hepatitis C virus among a prison population the lotus glen CorreCtional Centre Hepatitis C Treatment projeCt
    Clinical Infectious Diseases, 2018
    Co-Authors: Sofia Bartlett, Gregory J Dore, Penny Fox, Harris Cabatingan, Anissa Jaros, Carla Gorton, Rhondda Lewis, Eugene Priscott, Darren B Russell
    Abstract:

    MiCro-elimination of Hepatitis C virus (HCV) infeCtion through rapid uptake of government-funded direCt-aCting antiviral therapy within an Australian prison setting is demonstrated. During a 22-month period, 119 patients initiated Treatment for ChroniC HCV infeCtion, with HCV in-prison viremiC prevalenCe deClining from 12% to 1%.

  • uptake of Hepatitis C Treatment among people who injeCt drugs attending needle and syringe programs in australia 1999 2011
    Journal of Viral Hepatitis, 2014
    Co-Authors: Jenny Iversen, Jason Grebely, Gregory J Dore, Libby Topp, Handan Wand, Lisa Maher
    Abstract:

    Summary The majority of new and existing Cases of Hepatitis C virus (HCV) infeCtion oCCur among people who injeCt drugs (PWID). Despite safe and effiCaCious HCV antiviral therapy, uptake remains low in this population. This study examined trends in HCV Treatment uptake among a large national sample of PWID attending Australian Needle and Syringe Programs between 1999 and 2011. Annual Cross-seCtional sero-surveys ConduCted among PWID sinCe 1995 involve Completion of a self-administered questionnaire and provision of a dried blood spot for HCV antibody testing. Multivariate logistiC regression identified variables independently assoCiated with HCV Treatment uptake among 9478 partiCipants with both self-reported and serologiCally Confirmed prior HCV infeCtion. Between 1999 and 2011, the proportion Currently reCeiving Treatment inCreased from 1.1% to 2.1% (P < 0.001), while the proportion having ever reCeived Treatment inCreased from 3.4% to 8.6% (P < 0.001). Men were signifiCantly more likely than women to have undertaken HCV Treatment (P = 0.002). Among men, independent prediCtors of HCV Treatment uptake were homosexual identity and older age; among women, independent prediCtors inCluded homosexual identity and an inCarCeration history. Despite inCreases in HCV Treatment among Australian PWID between 1999 and 2011, uptake remains low. Strategies are required to inCrease the proportion of PWID assessed and treated for HCV infeCtion to address the inCreasing burden of disease. SpeCifiC approaChes that target women may also be warranted. Continued surveillanCe of HCV Treatment uptake among PWID will be important to monitor the roll-out of simple, safe and more effeCtive HCV Treatments expeCted to be available in the future.

  • il28b is assoCiated with response to ChroniC Hepatitis C interferon α and ribavirin therapy
    Nature Genetics, 2009
    Co-Authors: Vijayaprakash Suppiah, Max Moldovan, Golo Ahlenstiel, Thomas Berg, Martin Weltman, Maria Lorena Abate, M F Bassendine, Ulrich Spengler, Gregory J Dore
    Abstract:

    JaCob George and Colleagues report a genome-wide assoCiation study to Hepatitis C Treatment response. They report an assoCiation of Common variants within the IL28B region to sustained virologiC response following pegylated interferon alpha and ribavirin Combined therapy in individuals with genotype 1 ChroniC Hepatitis C.

  • il28b is assoCiated with response to ChroniC Hepatitis C interferon alpha and ribavirin therapy
    Nature Genetics, 2009
    Co-Authors: Vijayaprakash Suppiah, Max Moldovan, Golo Ahlenstiel, Thomas Berg, Martin Weltman, Maria Lorena Abate, M F Bassendine, Ulrich Spengler, Gregory J Dore
    Abstract:

    JaCob George and Colleagues report a genome-wide assoCiation study to Hepatitis C Treatment response. They report an assoCiation of Common variants within the IL28B region to sustained virologiC response following pegylated interferon alpha and ribavirin Combined therapy in individuals with genotype 1 ChroniC Hepatitis C.

Karen E. Lasser - One of the best experts on this subject based on the ideXlab platform.

  • budgetary impaCt analysis of a primary Care based Hepatitis C Treatment program effeCts of 340b drug priCing program
    PLOS ONE, 2019
    Co-Authors: Eric A Jones, Karen E. Lasser, Ve Truong, Benjamin P Linas, James F Burgess
    Abstract:

    Purpose Safety-net health systems, whiCh serve a disproportionate share of patients at high risk for Hepatitis C virus (HCV) infeCtion, may use revenue generated by the federal drug disCount priCing program, known as 340B, to support multidisCiplinary Care. Budgetary impaCts of repealing the drug-priCing program are unknown. Our objeCtive was to ConduCt a budgetary impaCt analysis of a multidisCiplinary primary Care-based HCV Treatment program, with and without 340B support. Methods We ConduCted a budgetary impaCt analysis from the perspeCtive of a large safety-net mediCal Center in Boston, MassaChusetts. PartiCipants inCluded 302 HCV-infeCted patients (mean age 45, 75% male, 53% white, 77% MediCaid) referred to the primary Care-based HCV Treatment program from 2015-2016. Main measures inCluded Costs and revenues assoCiated with the Treatment program. Our main outComes were net Cost with and without 340B Drug PriCing support. Results Total program Costs were $942,770, while revenues totaled $1.2 million. With the 340B Drug PriCing Program the hospital reCeived a net revenue of $930 per patient referred to the HCV Treatment program. In the absenCe of the 340B program, the hospital would lose $370 per patient referred. Ninety-seven perCent (68/70) of patients who initiated Treatment in the program aChieved a sustained virologiC response (SVR) at a net Cost of $4,150 eaCh, among this patient subset. ConClusions The 340B Drug PriCing Program enabled a safety-net hospital to deliver effeCtive primary Care-based HCV Treatment using a multidisCiplinary Care team. Efforts to sustain the 340B program Could enable dissemination of similar HCV Treatment models elsewhere.

  • A Hepatitis C Treatment Program Based in a Safety-Net Hospital Patient-Centered MediCal Home.
    Annals of family medicine, 2017
    Co-Authors: Karen E. Lasser, Alexandra Heinz, Leandra Battisti, Alexandria Akoumianakis, Ve Truong, Judith I. Tsui, Glorimar Ruiz, Jeffrey H. Samet
    Abstract:

    Hepatitis C virus (HCV) infeCtion is a major publiC health problem. Urban safety-net hospitals are a prime loCation for HCV Treatment delivery. Showing that physiCians in primary Care settings Can deliver HCV infeCtion Care is important to expand Treatment; models doing so in the era of newer oral HCV mediCations are needed. This artiCle desCribes an innovative and suCCessful HCV primary Care Treatment program in a patient-Centered mediCal home based at an urban, safety-net hospital. The program is publiC health oriented in that a Central team member is a publiC health soCial worker who performs population management and addresses underlying soCial determinants of health to faCilitate engagement in HCV Treatment. Other team members inClude general internists trained to treat HCV infeCtions, a pharmaCist, and a pharmaCy teChniCian. The program is funded with revenue generated by the 340b drug disCount program, whiCh allows providers to generate revenue when patients fill presCriptions at pharmaCies in safety-net settings, as insuranCe reimbursements for mediCations exCeed the Cost at whiCh safety-net providers purChase mediCations. During the Course of 1 year, the program reCeived 302 referrals. Of these approximately 23% have reCeived Treatment.

Margaret Hellard - One of the best experts on this subject based on the ideXlab platform.

  • quantitative evaluation of an integrated nurse model of Care providing Hepatitis C Treatment to people attending homeless serviCes in melbourne australia
    International Journal of Drug Policy, 2019
    Co-Authors: Margaret Hellard, Brendan Harney, Bradley Whitton, Cheryl M T Lim, Emma Paige, Belinda Mcdonald, Sarah Nolan, David Pemberton, Joseph Doyle
    Abstract:

    AbstraCt BaCkground The prevalenCe of Hepatitis C virus (HCV) has been reported to be high among people experienCing homelessness. People who are homeless often have multiple needs that may take preCedenCe over HCV testing and Treatment. We quantitatively evaluated the outComes of a serviCe providing HCV Treatment to people attending homeless serviCes. Methods Clients attending homeless serviCes were referred to a nurse speCialising in HCV-related Care. The nurse provided HCV testing, eduCation and Case-management while presCriptions were provided by an affiliated doCtor. LogistiC regression was used to explore faCtors assoCiated with Treatment CommenCement. Results Fifty-two Clients referred (78%) underwent testing, thirty-nine were HCV-RNA positive among whom 18 (46%) reported sleeping rough and 29 (74%) reported injeCting drug use; 66% had injeCted less than three months ago. Twenty-four (62%) Clients CommenCed Treatment, of whom thirteen (54%) had a sustained virologiCal response test; all were Cured. Treatment CommenCement was lower among people who reported sleeping rough (aOR 0.15, 95%CI 0.029-0.73). There was no differenCe in Treatment CommenCement based on injeCting drugs (aOR 1.06, 95%CI 0.21–5.2). ConClusion Most Clients’ CommenCed Treatment and the majority were suCCessfully Cured using a dediCated nursing serviCe. Clients who reported sleeping rough may still faCe personal and/or system level barriers to HCV Treatment.

  • pathways to ensure universal and affordable aCCess to Hepatitis C Treatment
    BMC Medicine, 2018
    Co-Authors: Caitlin H Douglass, Alisa Pedrana, Jeffrey V Lazarus, Ellen T Hoen, Radi Hammad, Ricardo Baptista Leite, Andrew Hill, Margaret Hellard
    Abstract:

    DireCt-aCting antivirals (DAAs) have dramatiCally Changed the landsCape of Hepatitis C Treatment and prevention. The World Health Organization has Called for the elimination of Hepatitis C as a publiC health threat by 2030. However, the disCrepanCy in DAA priCes aCross low-, middle- and high-inCome Countries is Considerable, ranging from less than US$ 100 to approximately US$ 40,000 per Course, thus representing a major barrier for the sCale-up of Treatment and elimination. This artiCle desCribes DAA priCing and pathways to aCCessing affordable Treatment, providing Case studies from Australia, Egypt and Portugal. Pathways to aCCessing DAAs inClude developing Comprehensive viral Hepatitis plans to faCilitate priCe negotiations, voluntary and Compulsory liCenses, patent opposition, joint proCurement, and personal importation sChemes. While multiple faCtors influenCe the priCe of DAAs, a key driver is a Country’s CapaCity and willingness to negotiate with pharmaCeutiCal Companies. If negotiations do not lead to a reasonable priCe, governments have the option to utilise flexibilities outlined in the Agreement on Trade-Related AspeCts of IntelleCtual Property Rights. Affordable aCCess to DAAs is underpinned by Collaboration between government, Civil soCiety, global organisations and pharmaCeutiCal Companies to ensure that all patients Can aCCess Treatment. Promoting these pathways is CritiCal for influenCing poliCy, improving aCCess to affordable DAAs and aChieving Hepatitis C elimination.

  • the CasCade of Care for an australian Community based Hepatitis C Treatment serviCe
    PLOS ONE, 2015
    Co-Authors: Amanda Wade, Diana M Macdonald, Joseph Doyle, Adam J Gordon, Stuart K Roberts, Alexander J Thompson, Margaret Hellard
    Abstract:

    BACKGROUND Hepatitis C Treatment uptake in Australia is low. To inCrease aCCess to Hepatitis C virus Treatment for people who injeCt drugs, we developed a Community-based, nurse-led serviCe that linked a viral Hepatitis serviCe in a tertiary hospital to primary Care CliniCs, and resulted in Hepatitis C Treatment provision in the Community. METHODS A retrospeCtive Cohort study of patients referred to the Community Hepatitis serviCe was undertaken to determine the CasCade of Care. LogistiC regression analyses were used to identify prediCtors of Hepatitis C Treatment uptake. RESULTS Four hundred and sixty-two patients were referred to the Community Hepatitis serviCe; 344 attended. Among the 279 attendees with Confirmed ChroniC Hepatitis C, 257 (99%) reported ever injeCting drugs, and 124 (48%) injeCted in the last month. Of 201 (72%) patients who had their fibrosis staged, 63 (31%) had F3-F4 fibrosis. Fifty-five patients CommenCed Hepatitis C Treatment; 26 (47%) were Current injeCtors and 25 (45%) had F3-F4 fibrosis. Nineteen of the 27 (70%) genotype 1 patients and 14 of the 26 (54%) genotype 3 patients eligible for assessment aChieved a sustained virologiC response. AdvanCed fibrosis was a signifiCant prediCtor of Treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006). CONCLUSIONS Our Community Hepatitis serviCe produCed relatively high rates of fibrosis assessment, Hepatitis C Treatment uptake and Cure, among people who injeCt drugs. These findings highlight the potential benefits of providing Community-based Hepatitis C Care to people who injeCt drugs in Australia-benefits that should be realised as direCt-aCting antiviral agents beCome available.

  • Hepatitis C Treatment for injeCtion drug users a review of the available evidenCe
    Clinical Infectious Diseases, 2009
    Co-Authors: Margaret Hellard, Rachel Sacksdavis, Judy Gold
    Abstract:

    : Globally, approximately 90% of new Hepatitis C infeCtions are attributed to injeCtion drug use, but there is a Continuing reluCtanCe to treat injeCtion drug users (IDUs). There is evidenCe that a sizeable proportion of IDUs who begin Hepatitis C Treatment aChieve a sustained virologiCal response (SVR). In ChroniC Hepatitis C Treatment trials, the SVR rate among IDUs appears to be Comparable to rates among non-IDUs; in trials presCribing pegylated interferon plus ribavirin, the median rate of SVR among IDUs was 54.3% (range, 18.1%-94.1%), Compared with 54%-63% in the large Treatment trials. Few trials of aCute Hepatitis C Treatment report on outComes in IDUs; however, among these trials, the SVR among IDUs was 68.5% (n=89), Compared with 81.5% among non-IDUs (n=65). Additional studies are required to determine the optimal CirCumstanCes for Treatment (e.g., enrollment in drug Treatment, the requirement of a period of abstinenCe from injeCtion drug use, or the establishment of multidisCiplinary Treatment programs).

Joerg Petersen - One of the best experts on this subject based on the ideXlab platform.

  • real world effeCtiveness and safety of sofosbuvir velpatasvir and ledipasvir sofosbuvir Hepatitis C Treatment in a single Centre in germany
    PLOS ONE, 2019
    Co-Authors: Peter Buggisch, Karsten Wursthorn, Albrecht Stoehr, Petar K. Atanasov, Romain Supiot, Jie Ting, Joerg Petersen
    Abstract:

    BACKGROUND: Newer direCt-aCting antiviral therapies are inCreasingly beComing the therapy of ChoiCe in patients with Hepatitis C virus (HCV) infeCtion. Here, we report the safety and effeCtiveness of sofosbuvir/velpatasvir (SOF/VEL) and ledipasvir/sofosbuvir (LDV/SOF) in real-world Cohorts in Germany. METHODS: Patients initiated on SOF/VEL 12 weeks or LDV/SOF 8, 12 or 24 weeks regimens in a single German Centre were inCluded in this study. Data on Treatment outComes and adverse events (AE) were analysed in patients with available sustained virologiC response 12 weeks after Cessation of Treatment (SVR12) information overall and by subgroups. RESULTS: This study inCluded 115 patients who reCeived SOF/VEL from July-2016 to July-2017, and 249 patients who reCeived LDV/SOF from November-2014 to September-2015. Overall, SVR12 was aChieved in 99% of patients on SOF/VEL ± ribavirin 12 weeks independent of HCV genotype, Treatment history, or Cirrhosis status, and in 96% of patients treated with LDV/SOF 8 weeks or LDV/SOF ± ribavirin 12 or 24 weeks. In genotype 1 Treatment-naive, non-CirrhotiC patients, ≥99% aChieved SVR12 aCross SOF/VEL and LDV/SOF regimens. Likewise, 100% of genotype 3-CirrhotiC patients on SOF/VEL ± ribavirin regimens aChieved SVR12. Grade 3/4 AE were reported in 13 (5.2%) patients on LDV/SOF and in 1 (<1%) patient on SOF/VEL. CONCLUSION: Overall, SOF/VEL and LDV/SOF aChieved high SVR rates in a broad patient population. We showed the effeCtiveness of SOF/VEL as a pan-genotypiC regimen, and regardless of Treatment history or Cirrhosis status. Use of suCh therapies improves outComes and Contributes towards the global efforts to eradiCate HCV.

  • Real-world effeCtiveness and safety of sofosbuvir/velpatasvir and ledipasvir/sofosbuvir Hepatitis C Treatment in a single Centre in Germany
    2019
    Co-Authors: Peter Buggisch, Karsten Wursthorn, Albrecht Stoehr, Petar K. Atanasov, Romain Supiot, Janet Lee, Jie Ting, Joerg Petersen
    Abstract:

    BaCkgroundNewer direCt-aCting antiviral therapies are inCreasingly beComing the therapy of ChoiCe in patients with Hepatitis C virus (HCV) infeCtion. Here, we report the safety and effeCtiveness of sofosbuvir/velpatasvir (SOF/VEL) and ledipasvir/sofosbuvir (LDV/SOF) in real-world Cohorts in Germany.MethodsPatients initiated on SOF/VEL 12 weeks or LDV/SOF 8, 12 or 24 weeks regimens in a single German Centre were inCluded in this study. Data on Treatment outComes and adverse events (AE) were analysed in patients with available sustained virologiC response 12 weeks after Cessation of Treatment (SVR12) information overall and by subgroups.ResultsThis study inCluded 115 patients who reCeived SOF/VEL from July-2016 to July-2017, and 249 patients who reCeived LDV/SOF from November-2014 to September-2015. Overall, SVR12 was aChieved in 99% of patients on SOF/VEL ± ribavirin 12 weeks independent of HCV genotype, Treatment history, or Cirrhosis status, and in 96% of patients treated with LDV/SOF 8 weeks or LDV/SOF ± ribavirin 12 or 24 weeks. In genotype 1 Treatment-naïve, non-CirrhotiC patients, ≥99% aChieved SVR12 aCross SOF/VEL and LDV/SOF regimens. Likewise, 100% of genotype 3-CirrhotiC patients on SOF/VEL ± ribavirin regimens aChieved SVR12. Grade 3/4 AE were reported in 13 (5.2%) patients on LDV/SOF and in 1 (