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Impact of Substance Use Disorder on the Rate of Sustained Virological Response in Veterans With Chronic Hepatitis C Treated With Direct-Acting Antivirals.

Publication ,  Journal Article
Ottman, AA; Townsend, ML; Hashem, MG; Britt, RB
Published in: Ann Pharmacother
June 2019

BACKGROUND: Substance use disorders (SUDs) are commonly encountered in patients with chronic hepatitis C virus (HCV) infection. It is important to consider the impact of SUDs on HCV treatment. OBJECTIVE: To compare the rate of clinical cure (sustained virological response at least 12 weeks after end of therapy [SVR12]) in veterans with chronic HCV infection treated with direct-acting antivirals (DAAs) with and without ongoing or recent substance use. METHODS: This single-center, retrospective cohort study evaluated 220 HCV patients treated with DAAs based on 2 groups: SUD (ongoing or recent substance use) or non-SUD (without ongoing or recent substance use). The primary end point was SVR12 achievement. Secondary end points included safety, adherence, early discontinuation, SVR12 achievement among SUD subgroups, and enrollment in a SUD treatment program. RESULTS: Most patients were African American men with an average age of 60 years and infected with HCV genotype 1. Almost half of the patients had advanced fibrosis or cirrhosis. There was no difference in SVR12 between groups (SUD: 96.2%; non-SUD: 94.3%; P = 0.54). Overall, 35.5% of patients missed at least 1 dose of DAA therapy, with a significant difference noted between groups (SUD: 44.5%; non-SUD: 26.4%; P = 0.005). Early discontinuation of DAA therapy was similar between groups. SVR12 among SUD subgroups ranged from 92.9% to 100%. In the SUD group, 27.3% of patients were enrolled in a SUD treatment program. Conclusion and Relevance: This study suggests that recent/ongoing substance use does not affect achievement of clinical cure of chronic HCV and reinforces treatment in this patient population.

Duke Scholars

Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

June 2019

Volume

53

Issue

6

Start / End Page

581 / 587

Location

United States

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Sustained Virologic Response
  • Substance-Related Disorders
  • Retrospective Studies
  • Pharmacology & Pharmacy
  • Middle Aged
  • Male
  • Humans
  • Hepatitis C, Chronic
 

Citation

APA
Chicago
ICMJE
MLA
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Ottman, A. A., Townsend, M. L., Hashem, M. G., & Britt, R. B. (2019). Impact of Substance Use Disorder on the Rate of Sustained Virological Response in Veterans With Chronic Hepatitis C Treated With Direct-Acting Antivirals. Ann Pharmacother, 53(6), 581–587. https://doi.org/10.1177/1060028018824988
Ottman, Andreina A., Mary L. Townsend, Mohamed G. Hashem, and Rachel B. Britt. “Impact of Substance Use Disorder on the Rate of Sustained Virological Response in Veterans With Chronic Hepatitis C Treated With Direct-Acting Antivirals.Ann Pharmacother 53, no. 6 (June 2019): 581–87. https://doi.org/10.1177/1060028018824988.
Ottman, Andreina A., et al. “Impact of Substance Use Disorder on the Rate of Sustained Virological Response in Veterans With Chronic Hepatitis C Treated With Direct-Acting Antivirals.Ann Pharmacother, vol. 53, no. 6, June 2019, pp. 581–87. Pubmed, doi:10.1177/1060028018824988.
Journal cover image

Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

June 2019

Volume

53

Issue

6

Start / End Page

581 / 587

Location

United States

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Sustained Virologic Response
  • Substance-Related Disorders
  • Retrospective Studies
  • Pharmacology & Pharmacy
  • Middle Aged
  • Male
  • Humans
  • Hepatitis C, Chronic