HIGH PREVALENCE OF WILLINGNESS TO USE DIRECT-ACTING ANTIVIRAL-BASED REGIMENS FOR HCV INFECTION AMONG HIV/HCV CO-INFECTED PEOPLE WHO USE DRUGS

Abstract

Objectives

Despite the high burden of hepatitis C virus (HCV)-related morbidity and mortality among HIV-positive people who use illicit drugs (PWUD), uptake of interferon-based treatments for HCV infection has been negligible among this group. Direct-acting antiviral (DAA) therapies offer an opportunity to expand treatment access among this population. The aim of this study was to explore willingness to use DAA-based regimens among HIV/HCV co-infected PWUD in Vancouver, Canada.

Methods

Data was drawn from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), a prospective cohort of HIV-positive PWUD. Using logistic regression analyses we investigated factors associated with willingness to use DAA-based regimens among HIV/HCV co-infected participants.

Results

Of 418 HIV/HCV co-infected PWUD surveyed between June 2014 and May 2015, 295 (71%) were willing to use DAA-based regimens. In multivariable analysis, participants enrolled in methadone maintenance therapy (Adjusted Odds Ratio [AOR] = 1.61, 95% Confidence Interval [CI]: 1.04–2.51), those with a recent assessment by an HCV specialist (AOR = 2.02, 95% CI: 1.28–3.19), and those who perceived that HCV infection was affecting their health (AOR = 2.49, 95% CI: 1.41–4.37) were more likely to be willing to use DAA-based regimens.

Conclusions

Overall, this study found high prevalence of willingness to use DAA-based regimens among HIV/HCV co-infected PWUD in Vancouver. Importantly, enrollment in methadone maintenance therapy was positively associated with willingness, suggesting that integrated models of HIV, HCV and addiction care should be explored as a way to address HCV-related morbidity and mortality among HIV/HCV co-infected PWUD.