Nuove sfide per i DAAs in Real-Life: la tossicodipendenza attiva non è una barriera al trattamento.

Background. We evaluated adherence and efficacy of DAA-regimens in a drug-users cohort.
Methods. Adherence of drug-users HCV patients was calculated as percentage of visits attended among those scheduled (monthly during treatment and follow-up). Regularity of medication uptake was investigated by questionnaires.
Results. 78 drug-users, who received at least one DAA-dose, were enrolled: 20 Active drug-users (group A, 25.6%), 10 Opioid Substitution Treatment patients (group B, 12.8%) and 18 rehab patients (group C, 23.1%); 30 (38.5%) fell into an A+B group. Percentage of patients 100% adherent to visit-schedule was high among those with more stability and support (groups B [90.0%] and C [88.9%]), but not significantly different from active-users (group A [80%]; p=0.472). More chaotic patients were those in A+B group (60.0% of fully-adherent patients; p=0.015). During treatment 75.6% never missed a visit. Full adherence was favoured by shorter regimens (83% vs. 63% in 24-weeks regimens; p=0.059), while no differences were observed according to HIV-coinfection, psychiatric comorbidities, imprisonment and unemployment. Overall 30 (38.5%) received a 24-weeks treatment, 26 (33.3%) with ribavirin. Per protocol SVR12 rate in 54 patients who completed treatment was 100%.
Conclusions. Although several clinical and social issues our data indicate that even active users can be highly adherent to DAAs with optimal cure-rates especially with shorter regimens.

Elisabetta Teti
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