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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24423

Title: Adherence to response-guided pegylated interferon and ribavirin for people who inject drugs with hepatitis C virus genotype 2/3 infection: the ACTIVATE study
Authors: Cunningham, Evan B.
Hajarizadeh, Behzad
Dalgard, Olav
Amin, Janaki
Hellard, Margaret
Foster, Graham R.
Bruggmann, Philip
Conway, Brian
Backmund, Markus
Robaeys, Geert
Swan, Tracy
Marks, Philippa S.
Quiene, Sophie
Applegate, Tanya L.
Weltman, Martin
Shaw, David
Dunlop, Adrian
Bruneau, Julie
Midgard, Havard
Bourgeois, Stefan
Thurnheer, Maria Christine
Dore, Gregory J.
Grebely, Jason
Issue Date: 2017
Citation: BMC INFECTIOUS DISEASES, 17, p. 1-12 (Art N° 420)
Abstract: Background: The aims of this analysis were to investigate treatment completion and adherence among people with ongoing injecting drug use or receiving opioid substitution therapy (OST) in a study of response-guided therapy for chronic HCV genotypes 2/3 infection. Methods: ACTIVATE was a multicenter clinical trial recruited between 2012 and 2014. Participants with genotypes 2/3 were treated with directly observed peg-interferon alfa-2b (PEG-IFN) and self-administered ribavirin for 12 (undetectable HCV RNA at week 4) or 24 weeks (detectable HCV RNA at week 4). Outcomes included treatment completion, PEG-IFN adherence, ribavirin adherence, and sustained virological response (SVR, undetectable HCV RNA >12 weeks post-treatment). Results: Among 93 people treated, 59% had recently injected drugs (past month), 77% were receiving OST and 56% injected drugs during therapy. Overall, 76% completed treatment. Mean on-treatment adherence to PEG-IFN and ribavirin were 98.2% and 94.6%. Overall, 6% of participants missed > 1 dose of PEG-IFN and 31% took <95% of their prescribed ribavirin., Higher treatment completion was observed among those receiving 12 vs. 24 weeks of treatment (97% vs. 46%, P < 0.001) while the proportion of participants with 95% on-treatment ribavirin adherence was similar between groups (67% vs. 72%, P = 0.664). Receiving 12 weeks of therapy was independently associated with treatment completion. No factors were associated with 95% RBV adherence. Neither recent injecting drug use at baseline nor during therapy was associated with treatment completion or adherence to ribavirin. In adjusted analysis, treatment completion was associated with SVR (aOR 23.9, 95% CI 2.9-193.8). Conclusions: This study demonstrated a high adherence to directly observed PEG-IFN and self-administered ribavirin among people with ongoing injecting drug use or receiving OST. These data also suggest that shortening therapy from 24 to 12 weeks can lead to improved treatment completion. Treatment completion was associated with improved response to therapy.
Notes: [Cunningham, Evan B.; Hajarizadeh, Behzad; Amin, Janaki; Marks, Philippa S.; Quiene, Sophie; Applegate, Tanya L.; Dore, Gregory J.; Grebely, Jason] UNSW Sydney, Kirby Inst, Sydney, NSW, Australia. [Dalgard, Olav; Midgard, Havard] Akershus Univ Hosp, Oslo, Norway. [Foster, Graham R.] Queen Mary Univ London, Liver Unit, London, England. [Bruggmann, Philip] Arud Ctr Addict Med, Zurich, Switzerland. [Conway, Brian] Vancouver Infect Dis Ctr, Vancouver, BC, Canada. [Backmund, Markus] Ludwig Maximilians Univ Munchen, Munich, Germany. [Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium. [Robaeys, Geert] UZ Leuven, Dept Hepatol, Leuven, Belgium. [Robaeys, Geert] UHasselt, Hasselt, Belgium. [Swan, Tracy] Treatment Act Grp, New York, NY USA. [Weltman, Martin] Nepean Hosp, Sydney, NSW, Australia. [Shaw, David] Royal Adelaide Hosp, Adelaide, SA, Australia. [Dunlop, Adrian] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia. [Hellard, Margaret] Burnet Inst, Melbourne, Vic, Australia. [Bruneau, Julie] Ctr Hosp Univ Montreal CRCHUM, Res Ctr, Montreal, PQ, Canada. [Bourgeois, Stefan] Stuivenberg ZNA, Antwerp, Belgium. [Thurnheer, Maria Christine] Univ Bern, Bern Univ Hosp, Dept Infect Dis, Bern, Switzerland.
URI: http://hdl.handle.net/1942/24423
DOI: 10.1186/s12879-017-2517-3
ISI #: 000403620800001
ISSN: 1471-2334
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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