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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24392

Title: Belgian experience with direct acting antivirals in people who inject drugs
Authors: Bielen, Rob
Moreno, Christophe
Van Vlierberghe, Hans
Bourgeois, Stefan
Mulkay, Jean-Pierre
Vanwolleghem, Thomas
Verlinden, Wim
Brixko, Christian
Decaestecker, Jochen
De Galocsy, Chantal
Janssens, Filip
Cool, Mike
Van Overbeke, Lode
Van Steenkiste, Christophe
D'heygere, Francois
Cools, Wilfried
Nevens, Frederik
Robaeys, Geert
Issue Date: 2017
Citation: DRUG AND ALCOHOL DEPENDENCE, 177, p. 214-220
Abstract: Background and aim: Hepatitis C viral infection (HCV) has become a curable disease due to the development of direct acting antivirals (DAA). The WHO has set a target to eliminate HCV completely. Therefore, people who inject drugs (PWID) also need to be treated. In this study, we compared the real-life uptake and outcome of DAA treatment for HCV in PWID and non-PWID. Methods: We performed a nation-wide, retrospective cohort study in 15 hospitals. All patients who were treated with simeprevir-sofosbuvir, daclatasvir-sofosbuvir, or ombitasvir/paritaprevir ritonavir dasabuvir between December 2013 and November 2015 were included. Results: The study population consisted of 579 patients: 115 PWID (19.9%) and 464 non-PWID (80.1%). Of the PWID 18 were active PWID (15.6%), 35 still received opiate substitution therapy (OST) (30.4%) and 62 were former PWID without OST (53.9%). PWID were more infected with genotype la and 3 (p = 0.001). There were equal rates of side-effects (44.7% vs. 46.6%; p = 0.847), similar rates of treatment completion (95.7% vs 98.1%; p = 0.244) and SVR (93.0% vs 94.8%; p = 0.430) between PWID and non-PWID, respectively. Conclusion: PWID, especially active users, are underserved for DAA treatment in real life in Belgium. Reimbursement criteria based on fibrosis stage make it difficult to treat PWID. Treatment adherence is similar in PWID and the general population, even in patients with active abuse. DAA were safe and effective in PWID despite the higher prevalence of difficult-to-treat genotypes. Based on these data more efforts to treat PWID are needed and policy changes are necessary to reach the WHO targets.
Notes: [Bielen, Rob] Hasselt Univ, Fac Med & Life Sci, Dept Gastroenterol & Hepatol, Ziekenhuis Oost Limburg, Genk, Belgium. [Moreno, Christophe] Erasme Univ Hosp, Dept Gastroenterol & Hepatopancreatol, Brussels, Belgium. [Van Vlierberghe, Hans] Univ Hosp Gent, Dept Hepatol & Gastroenterol, Ghent, Belgium. [Bourgeois, Stefan] ZNA Stuivenberg, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Mulkay, Jean-Pierre] Hop St Pierre & Erasme, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Vanwolleghem, Thomas; Verlinden, Wim] Univ Hosp UZ Antwerpen, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Brixko, Christian] CHR Citadelle, Dept Gastroenterol & Digest Oncol, Liege, Belgium. [Decaestecker, Jochen] KULeuven, Dept Gastroenterol & Hepatol, Univ Hosp, AZ Delta, Roeselare, Leuven, Belgium. [De Galocsy, Chantal] Hop HIS Bracops, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Janssens, Filip] KULeuven, Jessa Hosp, Dept Gastroenterol & Hepatol, Univ Hosp, Hasselt, Leuven, Belgium. [Cool, Mike] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, AZ Damiaan, Oostende, Leuven, Belgium. [Van Overbeke, Lode] AZ Sint Maarten, Dept Gastroenterol & Hepatol, Mechelen, Belgium. [Van Steenkiste, Christophe] Univ Hosp Gent, Dept Gastroenterol & Hepatol, AZ Maria Middelares, Ghent, Belgium. [D'heygere, Francois] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, AZ Groeninge, Kortrijk, Leuven, Belgium. [Cools, Wilfried] Hasselt Univ, Ctr Stat, Fac Sci, Diepenbeek, Belgium. [Nevens, Frederik] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, Leuven, Belgium. [Robaeys, Geert] KULeuven, Univ Hosp, Dept Gastroenterol & Hepatol, Ziekenhuis Oost Limbu, Leuven, Belgium.
URI: http://hdl.handle.net/1942/24392
DOI: 10.1016/j.drugalcdep.2017.04.003
ISI #: 000407666100029
ISSN: 0376-8716
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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