Hepatitis C virus (HCV) is the most common cause of chronic liver disease and the main risk factor is injection drug use. The development of direct-acting antiviral (DAA) treatments for HCV has improved the treatment of this condition. However, many patients do not have access to specialists to provide this treatment and there are concerns about its efficacy among individuals with substance use disorder. This report presents the outcomes of the first 75 patients who were treated with DAAs in an opioid treatment program.
- Of the 75 patients who initiated treatment, 10 were lost to follow-up and did not complete treatment.
- Among those who completed treatment, 98% achieved sustained virologic response – this was 85% of all those entering treatment.
Comments: This study adds to growing evidence of the efficacy of DAAs for treatment of HCV in a variety of settings and patient populations. It also refutes the arbitrary limitations that some payers place on patients (e.g., limiting treatment to those who are abstinent from alcohol and other drugs for at least 6 months) and clinicians (e.g., limiting treatment to specialists). We need to do more to expand HCV treatment; providing it in opioid treatment programs is one way to accomplish this.
Darius A. Rastegar, MD
Reference: Butner JL, Gupta N, Fabian C, et al. Onsite treatment of HCV infection with direct acting antivirals with an opioid treatment program. J Subst Abuse Treat. 2017;75:49–53.