Directly observed therapy for HCV successful even at extended intervals among PWIDs
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Key takeaways:
- Directly observed therapy was highly effective even at extended treatment dispensation intervals.
- Success appears to depend on access to treatment in a single visit vs. daily supervised ingestion.
BOSTON — Use of directly observed therapy was successful even at extended intervals when treating hepatitis C virus infection among people who inject drugs, according to research presented at The Liver Meeting.
Researchers in Vienna compared 239 people who inject drugs (PWIDs) on opioid agonist therapy who started directly observed therapy (DOT) with direct-acting antivirals during the COVID-19 pandemic (March 2020-October 2022) vs. a control group of 441 PWIDs receiving DOT before the pandemic (September 2014-March 2020).
Before COVID, 78.9% (n = 348) of PWIDs underwent daily DOT, while 4.3% (n = 19) received therapy two to three times per week and 16.8% (n = 74) once a week, according to the study.
During COVID, 31.4% (n = 75) of PWIDs received daily therapy, while 25.1% (n = 60) received therapy two to three times a week and 43.5% (n = 104) once a week.
The researchers reported comparable rates between COVID and pre-COVID groups in missed visits (0.8% vs. 0.4%) and sustained virologic response at 12 weeks (SVR12; 99.4% vs. 99.3%). However, loss of follow-up after treatment occurred more frequently during COVID (28.5% vs. 7.5%). Mortality was similar between groups (1.3% vs. 0.7%).
Directly observed therapy is “highly effective,” the researchers reported, even when therapy intervals were extended. However, the researchers noted that the success of the program relies on streamlined care and access to DAAs in a single visit to a low-threshold facility, rather than a strict daily supervised schedule.
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Schwarz C, et al. Individualized HCV treatment for PWIDs on opioid agonist therapy led to excellent adherence throughout the COVID19 pandemic. Presented at: The Liver Meeting; Nov. 10-14, 2023; Boston (hybrid meeting).
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