467. Real World Experience Treating HCV in Patients on Opioid Substitution Therapy in Rural Pennsylvania
Session: Poster Abstract Session: Hepatitis C
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Stainbrook HCV IDWeek 2016 FINAL Poster 467.pdf (211.5 kB)
  • Background: The newest epidemic of hepatitis C infections is occurring among younger people in rural areas in the United States. In Pennsylvania, the number of newly reported HCV infections among individuals ages 15 to 34 nearly doubled from 1,384 to 2,393 from 2003 to 2010. Screening efforts in this population have increased with the local Drug and Alcohol Commission offering free HCV testing to any individual who has at least one identifiable risk factor. Currently available direct acting antivirals can safely be used with opioid substitution therapy (OST) and provides an opportunity to link these patients to care. Infectious disease (ID) specialists are partners with community providers that come into contact with this population. We evaluated the effectiveness of linkage to HCV care in patients on OST at our rural ID clinic.

    Methods: Fifty-one patients referred to our ID clinic for HCV evaluation from various referral sources including psychiatry were identified. The treatment group consisted of 20 patients receiving OST with suboxone (55%), methadone (35%), or subutex (10%). 31 matched controls not on OST with similar demographics were identified for comparison. Chi-square testing was performed to determine differences in HCV cure between the two groups. Adverse events and rate of compliance with medical visits was assessed.

    Results: The majority of the fifty-one patients referred to our ID clinic for HCV evaluation were treated with SOF-based regimens. Patient demographics are described in Table 1. All patients on OST completed HCV treatment. Of patients on OST who have completed follow up, the interim SVR12 is 100%. In matched controls that were not on OST, the SVR12 is 100%. Treatment was well tolerated in both groups.

    Conclusion: SOF-based regimens provided high rates of SVR in patients on OST. Patients can safely be treated in the setting of OST and mental illness however may require a patient navigator to complete follow up. Linkage of these patients can be established by collaborative networks among methadone clinics, psychiatrists, and HCV specialists. Addressing drug addiction in rural America is vital to reducing the spread of hepatitis C.

    Tuesdae Stainbrook, DO MPH, Infectious Disease, DuBois Regional Medical Center, DuBois, PA and Sarjita Naik, PharmD, Gilead Sciences, Foster City, CA

    Disclosures:

    T. Stainbrook, Gilead: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
    BMS: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium

    S. Naik, Gilead: Employee , Salary

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    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.