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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24967

Title: Belgian Experience with Direct Acting Antivirals in People Who Inject Drugs.
Authors: Bielen, Rob
Van Vlierberghe, Hans
Bourgeois, Stefan
Moreno, Christophe
Vanwollegem, Thomas
Verlinden, Wim
Mulkay, Jean-Pierre
Decaestecker, Jochen
Cool, Mike
de Galocsy, Chantal
Van Overbeke, Lode
Janssens, Filip
Van Steenkiste, Christophe
D'heygere, Francois
Cools, Wilfried
Nevens, Frederik
Robaeys, Geert
Issue Date: 2016
Publisher: WILEY
Citation: HEPATOLOGY, 64, p. 457A-457A (Art N° 910)
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 1a 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; Robaeys, Geert] Hasselt Univ, Fac Med & Life Sci, Tongeren, Belgium. [Van Vlierberghe, Hans; Van Steenkiste, Christophe] Univ Hosp Gent, Dept Hepatol & Gastroenterol, Ghent, Belgium. [Bourgeois, Stefan] ZNA Stuivenberg, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Moreno, Christophe] Erasme Univ Hosp, Dept Gastroenterol & Hepatopancreatol, Brussels, Belgium. [Vanwollegem, Thomas; Verlinden, Wim] Univ Hosp UZAntwerpen, Dept Gastroenterol & Hepatol, Antwerp, Belgium. [Mulkay, Jean-Pierre] Hop St Pierre & Erasme, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Decaestecker, Jochen] AZ Delta, Dept Gastroenterol & Hepatol, Roeselare, Belgium. [Cool, Mike] AZ Damiaan, Dept Gastroenterol & Hepatol, Oostende, Belgium. [Decaestecker, Jochen; Cool, Mike; Janssens, Filip; Cools, Wilfried] Univ Hosp KULeuven, Dept Gastroenterol & Hepatol, Leuven, Belgium. [de Galocsy, Chantal] Hop HIS Bracops, Dept Gastroenterol & Hepatol, Brussels, Belgium. [Van Overbeke, Lode] AZ Sint Maarten, Dept Gastroenterol & Hepatol, Mechelen, Belgium. [Janssens, Filip] Jessa Hosp, Dept Gastroenterol & Hepatol, Hasselt, Belgium. [Van Steenkiste, Christophe] AZ Maria Middelares, Dept Gastroenterol & Hepatol, Ghent, Belgium. [D'heygere, Francois] AZ Groeninge, Dept Gastroenterol & Hepatol, Kortrijk, Belgium. [Cools, Wilfried] Hasselt Univ, Ctr Stat, Fac Sci Math & Stat, Hasselt, Belgium. [Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium.
URI: http://hdl.handle.net/1942/24967
ISI #: 000385493802177
ISSN: 0270-9139
Category: M
Type: Journal Contribution
Appears in Collections: Research publications

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