1
|
Wedemeyer H, Di Marco V, Garcia-Retortillo M, Teti E, Fraser C, Morano Amado LE, Rodriguez-Tajes S, Acosta-López S, O’Loan J, Milella M, Buti M, Guerra-Veloz MF, Ramji A, Fenech M, Martins A, Borgia SM, Vanstraelen K, Mertens M, Hernández C, Ntalla I, Ramroth H, Milligan S. Global Real-World Evidence of Sofosbuvir/Velpatasvir as a Highly Effective Treatment and Elimination Tool in People with Hepatitis C Infection Experiencing Mental Health Disorders. Viruses 2022; 14:v14112493. [PMID: 36423102 PMCID: PMC9695390 DOI: 10.3390/v14112493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Hepatitis C virus (HCV) is prevalent in people with mental health disorders, a priority population to diagnose and cure in order to achieve HCV elimination. This integrated analysis pooled data from 20 cohorts in seven countries to evaluate the real-world effectiveness of the pangenotypic direct-acting antiviral (DAA) sofosbuvir/velpatasvir (SOF/VEL) in people with mental health disorders. HCV-infected patients diagnosed with mental health disorders who were treated with SOF/VEL for 12 weeks without ribavirin as part of routine clinical practice were included. The primary outcome was sustained virological response (SVR) in the effectiveness population (EP), defined as patients with an available SVR assessment. Secondary outcomes were reasons for not achieving SVR, characteristics of patients with non-virological failures, adherence, and time from HCV RNA diagnosis to SOF/VEL treatment initiation. A total of 1209 patients were included; 142 did not achieve an SVR for non-virological reasons (n = 112; 83 lost to follow-up, 20 early treatment discontinuations) or unknown reasons (n = 30). Of the 1067 patients in the EP, 97.4% achieved SVR. SVR rates in the EP were ≥95% when stratified by type of mental health disorder and other complicating baseline characteristics, including active injection drug use and antipsychotic drug use. Of 461 patients with data available in the EP, only 2% had an adherence level < 90% and 1% had an adherence level < 80%; all achieved SVR. Patients with mental health disorders can be cured of HCV using a well-tolerated, pangenotypic, protease inhibitor-free SOF/VEL regimen. This DAA allows the implementation of a simple treatment algorithm, with minimal monitoring requirements and fewer interactions with central nervous system drugs compared with protease-inhibitor DAA regimens.
Collapse
Affiliation(s)
- Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, OE6810, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
- Correspondence: ; Tel.: +49-511-532-3305
| | - Vito Di Marco
- University of Palermo, Piazza Marina, 61, 90133 Palermo, Italy
| | - Montserrat Garcia-Retortillo
- Liver Section, Gastroenterology Department, Hospital del Mar-Parc de Salut Mar, Hospital del Mar Medical Research Institute (IMIM), C/ del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | | | - Chris Fraser
- Cool Aid Community Health Centre, 713 Johnson St, Victoria, BC V8W 1M8, Canada
| | - Luis Enrique Morano Amado
- Unit of Infectious Diseases, Álvaro Cunqueiro University Hospital, Estrada de Clara Campoamor, 341, 36312 Vigo, Spain
| | - Sergio Rodriguez-Tajes
- Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, C. de Villarroel, 170, 08036 Barcelona, Spain
| | - Silvia Acosta-López
- Digestive Diseases, Hospital Nuestra Señora de Candelaria, Ctra. Gral. del Rosario, 145, 38010 Tenerife, Spain
| | - Joss O’Loan
- Medeco Inala & Kombi Clinic, 55b/156 Inala Ave, Brisbane, QLD 4077, Australia
- School of Medicine, University of Queensland, St Lucia, Brisbane, QLD 4072, Australia
| | - Michele Milella
- Clinic of Infectious Diseases, University of Bari, Piazza Umberto I, 1, 70121 Bari, Italy
| | - Maria Buti
- Liver Unit, Vall d’Hebron University Hospital, and CIBEREHD del Instituto Carlos III, Barcelona, Spain
| | - María Fernanda Guerra-Veloz
- Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41003 Seville, Spain
- Clinical Research Fellow in Hepatology at King’s College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Alnoor Ramji
- University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mary Fenech
- Queensland Injectors Health Network (QuIHN), Treatment and Management Programme, 1 Hamilton Pl, Bowen Hills, Brisbane, QLD 4006, Australia
| | - Alexandra Martins
- Hospital Prof. Dr. Fernando Fonseca, IC19, 2720-276 Amadora, Portugal
| | - Sergio M. Borgia
- Infectious Diseases, William Osler Health System, 2100 Bovaird Dr E, Brampton, ON L6R 3J7, Canada
| | - Kim Vanstraelen
- Gilead Sciences Europe Ltd., Stockley Park, 2 Roundwood Ave, Hayes, Uxbridge UB11 1AS, UK
| | - Michael Mertens
- Gilead Sciences Europe Ltd., Stockley Park, 2 Roundwood Ave, Hayes, Uxbridge UB11 1AS, UK
| | - Cándido Hernández
- Gilead Sciences Europe Ltd., Stockley Park, 2 Roundwood Ave, Hayes, Uxbridge UB11 1AS, UK
| | - Ioanna Ntalla
- Gilead Sciences Europe Ltd., Stockley Park, 2 Roundwood Ave, Hayes, Uxbridge UB11 1AS, UK
| | - Heribert Ramroth
- Gilead Sciences Europe Ltd., Stockley Park, 2 Roundwood Ave, Hayes, Uxbridge UB11 1AS, UK
| | - Scott Milligan
- Trio Health Analytics, 1025 Cannon Street, Suite 2C, Louisville, CO 80027, USA
| |
Collapse
|