The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.

Among patients with hepatitis C virus (HCV) infection with a history of injectable drug use, those who underwent rapid treatment with a 7-day course of sofosbuvir-velpatasvir achieved significantly increased cure rates compared with those treated with usual care, according to research presented at IDWeek, held virtually from September 29 to October 3, 2021.

 Researchers conducted a study on patients aged 18 to 29 years with HCV who were treatment naïve and had used injectable drugs within the past 30 days. Patients were randomly assigned in a 1:1 fashion to receive either rapid treatment with sofosbuvir-velpatasvir or usual care. In addition to a 7-day course of sofosbuvir-velpatasvir, patients in the rapid treatment group received a same-day medical evaluation, confirmatory and baseline laboratory testing. Patients in the usual care group received same-day HCV confirmation and facilitated referral to a local healthcare provider. The primary endpoint was sustained virologic response at 12 months.


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Of 38 participants included in the study, 14 in the rapid treatment group (n=18) and 11 in the usual care group (n=20) were included in the intention-to-treat analysis. Of patients in both treatment groups, the mean age was 26, 24% were women;,36% identified as Hispanic, and 4% identified as non-Hispanic Black. At baseline, 24% of patients were homeless, 52% had received treatment for opioid use disorder within the past 90 days, and the median number of injectable drugs used within the past 30 days was 20 among the included participants. On analysis of the intention-to-treat population, 9 patients (64%) in the rapid treatment group and 2 (18%) in the usual care group achieved a sustained virologic response (P =.042). Of 5 patients in the rapid treatment group who did not achieve a sustained virologic response, 1 experienced treatment failure, 1 did not start treatment, 1 had an on-treatment response pending confirmation of sustained virologic response, and 2 were lost to follow-up.

“Initiating HCV treatment ‘in the moment’ without the need for repeat visits appears to be a promising strategy for treating this hard to reach [patient] population,” the researchers concluded.

Reference

Eckhardt B, Kapadia S, Smith M, et al. Rapid hepatitis C treatment initiation in young people who inject drugs: final results from the HCV-seek, test & rapid treatment (HCV-ST&RT) randomized pilot clinical trial. Presented at: IDWeek; September 29 to October 3, 2021. Poster 911.

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