Swiss OAT programmes on their way to HCV elimination - The SAMMSU cohort

In order to eliminate hepatitis C, as provided for by the Swiss Hepatitis Strategy and the Global Health Sector Strategy of the WHO, hepatitis C treatment in particular must be guaranteed for people with substance use.

The SAMMSU cohort is an open cohort that includes persons with current or former drug use in all parts of Switzerland. This cohort also investigates hepatitis C care for opioid agonist therapy (OAT) patients in 8 centres.

By May 1, 2018, 755 patients had been enrolled in the cohort study: 82% with ever i.v. drug use, 14% were HIV positive, 67% were hepatitis C antibodies positive.

The development of the new hepatitis C drugs is impressively reflected in the study results:

• The success rate of the therapy increased from 56% (in the interferon age) to 97% (among the new, interferon-free therapies).
• Therapy duration decreased and tolerability improved.
• The new therapy was not discontinued by any person, whereas 18% of the patients treated received interferon.
• From May 1, 2017 to May 1, 2018, the proportion of patients with chronic hepatitis C ever treated increased from 55% to 65%.
• HCV RNA prevalence decreased from 41% to 27% (see figure).

Within the centers of the SAMMSU cohort study, there is progress towards the elimination of hepatitis C. These experiences must now be used outside the study setting.

The number of patients treated at all SAMMSU centers increased significantly from 2017 to 2018 (green bars). At the same time, the number of people with chronic, untreated hepatitis C (red bars) decreased.

Authors of the study:
Andrea Bregenzer, Philip Bruggmann, Erika Castro, Alberto Moriggia, Madeleine Rothen, Maria-Christine Thurnheer, Pietro Vernazza, Claude Scheidegger