Hepatitis C Treatment Is Safe and Effective for Injection Drug Users

Patients with hepatitis C (HCV) who are being treated for opioid addiction achieved high rates of sustained virologic response at 12 weeks (SVR12) when they were given elbasvir-grazoprevir, according to the results of a recent study.

HCV is common in persons who inject drugs (PWID). In order to evaluate the effectiveness of elbasvir-grazoprevir in this group of people, researchers conducted a placebo-controlled, double-blind, randomized trial of 301 treatment-naïve patients with chronic HCV genotype 1, 4, or 6 who were at least 80% adherent to visits for opioid-agonist therapy.
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The participants were randomly assigned either to receive elbasvir-grazoprevir for 12 weeks (immediate treatment group) or to receive placebo for 12 weeks, followed by no treatment for 4 weeks, then elbasvir-grazoprevir for 12 weeks (deferred treatment group).

Overall, SVR12 was 91.5% in the immediate treatment group and 89.5% in the deferred treatment group. Drug use at baseline and during treatment had no effect on SVR12 or adherence to HCV treatment.

“Patients with HCV infection who were receiving [opioid-agonist therapy] and treated with elbasvir–grazoprevir had high rates of SVR12, regardless of ongoing drug use,” the researchers concluded. “These results support the removal of drug use as a barrier to interferon-free HCV treatment for patients receiving [opioid-agonist therapy].”

—Michael Potts

Reference:

Dore GJ, Altice F, Litwin AH, et al; C-EDGE CO-STAR Study Group. Elbasvir–grazoprevir to treat hepatitis C virus infection in persons receiving opioid agonist therapy: a randomized trial [published online August 9, 2016]. Ann Intern Med. doi:10.7326/M16-0816.