Directly Acting Antiviral-Based Treatment for HCV-Infected Persons Who Inject Drugs: A Multicenter Real-Life Study

• Main Authors: Vincenzo Messina, Lorenzo Onorato, Giovanni Di Caprio, Ernesto Claar, Vincenzo Iovinella, Antonio Russo, Valerio Rosato, Angela Salzillo, Riccardo Nevola, Filomena Simeone, Fabio Curcio, Mariantonietta Pisaturo, Nicola Coppola
• Format: Article
• Language: English
• Published: MDPI AG 2021-12-01
• Series: Life
• Subjects: PWID; DAA; HCV infection; HCV chronic hepatitis; HCV treatment; interferon-free
• Online Access: https://www.mdpi.com/2075-1729/11/1/17

Background: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infected people who inject drugs (PWID) treated with direct acting antivirals (DAAs). Methods: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated with DAAs. The primary outcome evaluated was the sustained virological response (SVR12) rate. Results: Five hundred and twenty HCV-infected PWID treated with all-oral DAA-based regimens were enrolled; a total of 168 (32.3%) patients presented genotype 1a, 109 (21.0%) genotype 1b, and 174 (33.5%) genotype 3; a total 152 of the 520 subjects (29.2%) were cirrhotics; a total 118 (22.7%) and 373 (71.7%) were treated with DAA regimens of second and third generation, respectively; a total 169 (33.6%) patients were receiving an opioid agonist at the start of antiviral therapy. Only 11 subjects (2.1%) did not show an SVR12. A significant correlation was found between treatment with opioid substitution therapy (<i>p </i>< 0.001), Human Immunodeficiency Virus (HIV) coinfection (<i>p </i>= 0.002), and treatment with first- or second-generation regimens (<i>p </i>= 0.0015) and HCV failure. Upon multivariate analysis, treatment with a first- or second-generation DAA was the only factor independently associated with failure (OR 10.4, 95% CI: 1.43 to 76.1, <i>p </i>= 0.02). Conclusions: Treatment with DAAs led to a high SVR12 rate (97.9%) in a large cohort of HCV-infected PWID. The only predictor of viral failure found in our analysis was treatment with first- and second-generation DAA.