The results of a study conducted by internists Nathalie Scherz, Philip Bruggmann and Nathalie Brunner in the Arud have now been published in the renowned journal "International Journal of Drug Policy".
The aim of the study was to investigate how hepatitis C treatment with modern DAA (direct-acting antivirals) drugs works in people undergoing opioid agonist (OAT) therapy.
Data from 64 patients undergoing OAT treatment at Arud between October 2014 and August 2017 were evaluated retrospectively.
Very high cure rate in opioid-dependent patients
The results clearly indicate the efficacy of HCV treatment with DAA in patients with opioid dependence: 59 (92.2%) of the 64 patients included in the study were cured (SVR, sustained virological response). It should be emphasized that all 9 patients who injected drugs intravenously during the treatment period could also be cured of hepatitis C (100%).
Study performed under real conditions
The study is the first of its kind to provide data on the efficacy of DAA therapy in patients undergoing OAT treatment in real-life situations and thus to support the applicable international therapy guidelines. Thus 78% of the study participants showed psychiatric concomitant diseases, 14% injected drugs intravenously and 41% consumed alcohol to an extent harmful to health. Despite these circumstances, cure rates were comparable to those of the general population.
Appropriate setting crucial for therapeutic success
The interdisciplinary setting that Arud offers its patients plays an important role in the success of the therapy and makes it possible to integrate this often difficult to reach group of patients into the therapy. Success factors include:
- Empathetic, non-evaluating staff with flexible appointment arrangements
- Many years of experience of the staff in demanding blood samples
- Interdisciplinary on-site services with integrated psychiatric care and basic medical care. Patients therefore did not have to make additional appointments with specialists.
- Support regarding adherence was not mandatory; patients were always involved in decision-making processes.
- The frequency of consultations was flexible and tailored to the needs of the individual patient.
Substance consumption is not an exclusion criterion
The study clearly demonstrated that the treatment of hepatitis C with DAA drugs is both appropriate and highly effective in patients undergoing OAT treatment. Active alcohol or intravenous substance use are not exclusion criteria for hepatitis C therapy. Important for the success of the therapy is the interdisciplinary treatment on site and a supportive and non-evaluative attitude of the medical staff towards the patients.