Most HIV/HCV-Positive Individuals Who Use Drugs Willing to Start HCV Treatment

published on April 4, 2017 by Mark Mascolini in The Body Pro

Nearly three-quarters of HIV/hepatitis C (HCV)-coinfected drug users in Vancouver, Canada, reported willingness to use direct-activing antivirals (DAAs) for HCV infection, a substantial improvement over the willingness of this group to use interferon-based regimens. Enrollment in methadone maintenance programs predicted willingness to use DAAs.

Compared with HCV-monoinfected people, those coinfected with HIV are less likely to clear HCV spontaneously and more likely to progress to end-stage liver disease, hepatocellular carcinoma and death. HCV treatment rates have been low in drug injectors because potential patients may fear side effects, providers may be reluctant to prescribe for these people, and access to treatment may be low. Yet, research indicates that drug users achieve sustained virologic response rates similar to those of the general population.

To assess prevalence and correlates of willingness to use DAAs among HIV/HCV-coinfected drug users, researchers in Vancouver conducted this analysis of the ACCESS group, an ongoing prospective cohort of HIV-positive drug users. Cohort members are at least 18 years old, live in greater Vancouver and use illicit drugs other than marijuana. Cohort members complete an interviewer-administered questionnaire, which has included questions about HCV knowledge and willingness to use DAAs since June 2014.

Between June 2014 and May 2015, 418 HIV/HCV-coinfected cohort members completed the questionnaire. Median age stood at 44 years (interquartile range 37 to 48), 63% were men, 67% had seen an HCV specialist in the past six months and 53% were enrolled in methadone maintenance therapy. Whereas 95% of survey respondents were taking antiretroviral therapy, only 9% had received HCV therapy.