Sofosbuvir-Velpatasvir vs. Glecaprevir-Pibrentasvir for hepatitis C infection in drug users

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Created On: 24/12/2024

This retrospective chart review-based study examined the safety and effectiveness of two antiviral regimes- Glecaprevir-Pibrentasvir (G-P) and Sofosbuvir-Velpatasvir (S-V) in a high-volume community-based program focused on diagnosis and care engagement for those who use drugs.

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Key take away

High treatment success and completion rates for hepatitis C can be achieved in active drug users with either Sofosbuvir-Velpatasvir or Glecaprevir-Pibrentasvir, proving their safety and effectiveness.

Background

Method

Patients were identified at outreach events, and viremic individuals were offered hepatitis C virus (HCV) treatment through a multidisciplinary program. The first 120 patients who chose a treatment option (G-P or S-V) and had definitive outcomes were assessed. HCV cure rates, correlates, and the safety of the therapies were the main outcome measures.

Result

One hundred and twenty patients in each treatment group were identified:

Among those receiving G-P, 28.3% were female, 20.9% were Indigenous, 70.8% were using fentanyl, and 51.3% had unstable housing.
Among those receiving S-V, 25.8% were female, 20.8% were Indigenous, 75% used fentanyl, and 56.7% had unstable housing.

Overall, 118 patients completed therapy with G-P, while 115 completed with S-V. Three patients on G-P and two on S-V experienced virologic relapse. The intention-to-treat (ITT) and modified intention-to-treat (mITT) cure rates were 95.0%/97.4% for G-P and 94.2%/98.3% for S-V. Among those who started treatment, 5 drug overdose deaths were reported (1 in the G-P group; 4 in the S-V group).

Conclusion

Greater than 90% success rates were achieved with the use of G-P and S-V regimens, supporting the effectiveness of both options for individuals who use drugs and have HCV infection.