A comparison of sofosbuvir/velpatasvir and glecaprevir/pibrentasvir for the treatment of hepatitis C infection among people who inject drugs

IF 3.5 4区医学 Q2 IMMUNOLOGY Journal of Virus Eradication Pub Date : 2024-09-01 DOI:10.1016/j.jve.2024.100388

Shana Yi , David Truong , Brian Conway

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Abstract

Background

To eliminate hepatitis C (HCV) infection as a public health concern by 2030, there is a need to develop comprehensive programs among key populations such as people who use drugs (PWUD). Two highly effective regimens are available for initial therapy: glecaprevir/pibrentasvir (G/P) given as 3 tablets/day for 8 weeks and sofosbuvir/velpatasvir (S/V) given as 1 tablet/day for 12 weeks. Data evaluating the safety and efficacy comparing one regimen over another in a population of PWUD is limited.

Methods

Patients were identified through outreach events. Viremic patients were offered HCV treatment within a multidisciplinary program. This retrospective comparison analysis focuses on the first 120 sequential individuals who chose either treatment and in whom a definitive outcome of treatment was available between March 1, 2019 and February 29, 2024. The primary outcomes of the analysis were cure of HCV infection and its corelates, as well as safety of the individual regimens.

Results

We successfully identified 120 within each of the G/P and S/V treatment groups. Of those on G/P, we note 28.3 % female, 20.9 % Indigenous, 70.8 % using fentanyl, and 51.3 % with unstable housing. Of those on S/V, we note 25.8 % female, 20.8 % Indigenous, and 75 % using fentanyl and 56.7 % with unstable housing. Overall, 118 and 115 patients completed therapy on G/P and S/V, respectively. A total of 118 and 115 completed therapy on G/P and S/V, with virologic relapse documented in 3 and 2 participants on G/P and S/V, respectively. The ITT/mITT cure rates for G/P and S/V were 95.0 %/97.4 % and 94.2 %/98.3 %, respectively. There were 5 drug overdose deaths among those who initiated treatment, one on G/P and 4 on S/V. Conclusion: We have evaluated two highly effective regimens in a group of inner-city PWUD, with comparable success rates well in excess of 90 %. Our data supports the offer of both options for the treatment of PWUD with HCV infection.

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比较索非布韦（sofosbuvir）/韦帕他韦（velpatasvir）和格列卡普韦（gelecaprevir）/皮布伦特韦（pibrentasvir）治疗注射吸毒者丙型肝炎感染的效果

背景为了到 2030 年消除丙型肝炎（HCV）感染这一公共卫生问题，有必要在吸毒者（PWUD）等关键人群中制定综合计划。目前有两种高效的初始治疗方案：格列卡普韦/匹布伦达韦（G/P），3片/天，疗程8周；索非布韦/韦帕他韦（S/V），1片/天，疗程12周。在感染者和非感染者人群中，评估一种治疗方案与另一种治疗方案的安全性和有效性的数据非常有限。病毒携带者可在多学科计划内接受 HCV 治疗。这项回顾性比较分析主要针对选择其中一种治疗方案的前 120 名连续患者，这些患者在 2019 年 3 月 1 日至 2024 年 2 月 29 日期间获得了明确的治疗结果。分析的主要结果是治愈 HCV 感染及其核心候选者，以及各个治疗方案的安全性。在接受 G/P 治疗的患者中，女性占 28.3%，土著占 20.9%，使用芬太尼的占 70.8%，住房不稳定的占 51.3%。在接受 S/V 治疗的患者中，女性占 25.8%，土著人占 20.8%，使用芬太尼的占 75%，住房不稳定的占 56.7%。总体而言，分别有 118 名和 115 名患者完成了 G/P 和 S/V 治疗。分别有 118 名和 115 名患者完成了 G/P 和 S/V 治疗，其中分别有 3 名和 2 名接受 G/P 和 S/V 治疗的患者出现病毒学复发。G/P和S/V的ITT/mITT治愈率分别为95.0%/97.4%和94.2%/98.3%。在开始接受治疗的患者中，有 5 例药物过量死亡，其中 1 例死于 G/P 疗法，4 例死于 S/V 疗法。结论：我们在一群市内吸毒者中评估了两种非常有效的治疗方案，成功率相当，远远超过 90%。我们的数据支持将这两种方案用于治疗感染丙型肝炎病毒的艾滋病感染者。

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来源期刊

Journal of Virus Eradication Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.10

自引率

1.80%

发文量

审稿时长

39 weeks

期刊介绍： The Journal of Virus Eradication aims to provide a specialist, open-access forum to publish work in the rapidly developing field of virus eradication. The Journal covers all human viruses, in the context of new therapeutic strategies, as well as societal eradication of viral infections with preventive interventions. The Journal is aimed at the international community involved in the prevention and management of viral infections. It provides an academic forum for the publication of original research into viral reservoirs, viral persistence and virus eradication and ultimately development of cures. The Journal not only publishes original research, but provides an opportunity for opinions, reviews, case studies and comments on the published literature. It focusses on evidence-based medicine as the major thrust in the successful management of viral infections.The Journal encompasses virological, immunological, epidemiological, modelling, pharmacological, pre-clinical and in vitro, as well as clinical, data including but not limited to drugs, immunotherapy and gene therapy. It is an important source of information on the development of vaccine programs and preventative measures aimed at virus eradication.