Direct-acting antiviral (DAA) treatment is highly effective at curing hepatitis C in people who inject drugs and in people receiving opioid substitution therapy (OST), a systematic review and meta-analysis of 38 studies published in The Lancet Gastroenterology and Hepatology shows. Experts from Australia’s leading hepatitis C research centre say that the findings of the review demonstrate that policies that deny hepatitis C treatment for people who use drugs are unacceptable.
The findings were published to coincide with the 7th International Symposium on Hepatitis Care in Substance Users, which took place last week in Portugal.
Despite a recommendation from the World Health Organization that people who use drugs should receive DAA treatment for hepatitis C, some countries do not provide treatment to active drug users and physicians often cite concern about adherence as a reason to deny treatment to active drug users.
The meta-analysis showed a sustained virologic response (SVR) rate of 87.7% in recent drug users and an SVR rate of 90.7% in OST recipients. Treatment completion rates were high (97.5% in both recent drug users and OST recipients).
When the analysis was confined to people with recent injecting drug use, rather than all drug use, the SVR rate was 87.4% (treatment completion rate was 96.9%).
"People should not be denied life-saving treatments, simply because of their recent drug use," said Associate Professor Jason Grebely from the Kirby Institute at the University of New South Wales.
"Policies that deny hepatitis C treatment for people who use or inject drugs are unacceptable; they are driven by discrimination as opposed to evidence. I hope our research will encourage countries to overturn these policies and allow treatment to all people living with hepatitis C, regardless of current or previous drug use.”
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