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Hepatitis C treatment at a Swedish needle exchange program, a successful model of care – the ACTIONNE study

Blomé, Marianne Alanko LU ; Bråbäck, Martin LU ; Alsterberg, Sara and Jerkeman, Anna LU (2021) In International Journal of Drug Policy 96.
Abstract

Background: To engage people who inject drugs (PWID) in HCV care, innovative models of care are urgently needed. A needle exchange program (NEP) could serve as an ideal platform for comprehensive HCV management including post treatment follow up. Methods: 50 actively injecting patients at the Malmö Needle exchange program (MNEP) were consecutively enrolled between April 2018 and May 2019. All patients received a fixed-dose combination of once-daily glecaprevir/pibrentasvir for 8 or 12 weeks. Patients were monitored weekly during treatment and data on adherence and side effects was recorded. The primary endpoint was SVR12. Adherence to treatment was the secondary endpoint. Results: 47/50 (94%) patients completed treatment. 45/50 were HCV... (More)

Background: To engage people who inject drugs (PWID) in HCV care, innovative models of care are urgently needed. A needle exchange program (NEP) could serve as an ideal platform for comprehensive HCV management including post treatment follow up. Methods: 50 actively injecting patients at the Malmö Needle exchange program (MNEP) were consecutively enrolled between April 2018 and May 2019. All patients received a fixed-dose combination of once-daily glecaprevir/pibrentasvir for 8 or 12 weeks. Patients were monitored weekly during treatment and data on adherence and side effects was recorded. The primary endpoint was SVR12. Adherence to treatment was the secondary endpoint. Results: 47/50 (94%) patients completed treatment. 45/50 were HCV negative at 12 weeks post treatment giving an SVR12 rate per ITT of 90% and an SVR12 rate per protocol of 96%. One patient showed reinfection 12 weeks post treatment and one patient was lost to follow up and did not produce an SVR12 result. The mean adherence per week, according to pill count, was 98%. Conclusion: Our study shows that the NEP can be a useful tool for engaging actively injecting PWID in HCV management and that SVR rates, comparable to those in non-PWID settings, can be achieved.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hepatitis C, Models of care, Needle exchange program, People who inject drugs
in
International Journal of Drug Policy
volume
96
article number
103407
publisher
Elsevier
external identifiers
  • scopus:85112553569
  • pmid:34391622
ISSN
0955-3959
DOI
10.1016/j.drugpo.2021.103407
language
English
LU publication?
yes
id
e8524564-7b5c-4b28-84c9-d075ecb21f71
date added to LUP
2021-09-17 08:40:50
date last changed
2024-06-15 16:21:09
@article{e8524564-7b5c-4b28-84c9-d075ecb21f71,
  abstract     = {{<p>Background: To engage people who inject drugs (PWID) in HCV care, innovative models of care are urgently needed. A needle exchange program (NEP) could serve as an ideal platform for comprehensive HCV management including post treatment follow up. Methods: 50 actively injecting patients at the Malmö Needle exchange program (MNEP) were consecutively enrolled between April 2018 and May 2019. All patients received a fixed-dose combination of once-daily glecaprevir/pibrentasvir for 8 or 12 weeks. Patients were monitored weekly during treatment and data on adherence and side effects was recorded. The primary endpoint was SVR12. Adherence to treatment was the secondary endpoint. Results: 47/50 (94%) patients completed treatment. 45/50 were HCV negative at 12 weeks post treatment giving an SVR12 rate per ITT of 90% and an SVR12 rate per protocol of 96%. One patient showed reinfection 12 weeks post treatment and one patient was lost to follow up and did not produce an SVR12 result. The mean adherence per week, according to pill count, was 98%. Conclusion: Our study shows that the NEP can be a useful tool for engaging actively injecting PWID in HCV management and that SVR rates, comparable to those in non-PWID settings, can be achieved.</p>}},
  author       = {{Blomé, Marianne Alanko and Bråbäck, Martin and Alsterberg, Sara and Jerkeman, Anna}},
  issn         = {{0955-3959}},
  keywords     = {{Hepatitis C; Models of care; Needle exchange program; People who inject drugs}},
  language     = {{eng}},
  month        = {{08}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Drug Policy}},
  title        = {{Hepatitis C treatment at a Swedish needle exchange program, a successful model of care – the ACTIONNE study}},
  url          = {{http://dx.doi.org/10.1016/j.drugpo.2021.103407}},
  doi          = {{10.1016/j.drugpo.2021.103407}},
  volume       = {{96}},
  year         = {{2021}},
}