HepCInfo Updates

HepCInfoUpdate 7.16 

Welcome to CATIE's HepCInfo Update 7.16 for August 20 to September 2, 2016. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

One study shows HIV not a risk factor for liver injury progression in people with HIV and hepatitis C

HIV co-infection was not association with progression of liver injury in people with hepatitis C, reported researchers in the Journal of Infectious Diseases.

The study included 378 people who had two or more liver biopsies between 1997 and 2013.  Approximately one-third were co-infected with HIV and hepatitis C.

The average time between first and last biopsies was seven years and the average time in between two biopsies was four years.

During follow up 57% of people advanced one fibrosis  stage, 16% progressed two stages and 7% developed severe liver injury (cirrhosis).

No association was observed between liver injury progression and HIV and hepatitis C co-infection. However, the researchers thought that this could potentially be explained by the well-controlled HIV viral load in participants co-infected with HIV and hepatitis C. Further research is needed about the impact of HIV on liver injury progression in people with HIV and hepatitis C. (aidsmap.com, August 2016)

Epclusa effective in people who are using OST

In the late-stage clinical trials of Epclusa, the cure rates for participants on opiate substitution therapy (OST; 96%) were similar to those who were not on OST (95% to 99%), reported researchers in Clinical Infectious Diseases.

The researchers pooled data from five late-stage clinical trials of Epclusa. Epclusa is a combination of sofosbuvir and velpatasvir and is approved in Canada for viral genotypes 1 to 6.

Of the 1035 participants in all the late-stage trials, 51 were using OST.  OST use did not affect the likelihood of completing treatment or maintaining at least 90% adherence. However, those on OST with less than 90% adherence had lower cure rates that those who had higher adherence (60% versus 100%).

Treatment was safe and well tolerated for participants on OST. There no reinfections during six months post-treatment.

The researchers concluded that “OST use during treatment did not impact treatment completion, adherence, cure rate or safety.” (HIVandhepatitis.com, September 2016)

High cure rates with Harvoni in people who are using OST and/or street drugs

In late-stage clinical trials of Harvoni, participants who were on opiate substitution therapy (OST) and/or using street drugs had similar cure rates (94%) to the total cure rates for the other late-stage trials (93% to 99%), reported researchers in Clinical Infectious Diseases.

Harvoni is a combination of sofosbuvir and ledipasvir. It is approved in Canada for genotype 1 virus.

There were 1952 participants in the late stage trials of Harvoni, 70 of whom were receiving OST. Stored samples of all participants blood was tested after the trials were over for street drug use. Almost a quarter of the blood samples tested positive for street drug use, the majority of which was marijuana use (15%) and other drug use (8%).

Street drug use or OST use did not affect treatment completion or maintaining at least 80% adherence. The researchers also did not find any cases of reinfection six months after the end of the study. (HIVandhepatitis.com, September 2016)

Straight to the source for new science

The Population Level Cascade of Care for Hepatitis C in British Columbia, Canada: The BC Hepatitis Testers Cohort (BC-HTC), EBioMedicine, August 2016

Food Insecurity in HIV-Hepatitis C Virus Co-infected Individuals in Canada: The Importance of Co-morbidities, AIDS Behavior, 2016