High adherence to all-oral directly acting antiviral HCV therapy among an inner-city patient population in a phase 2a study

摘要

BackgroundAs treatment for chronic hepatitis C (HCV) virus has evolved to all-oral, interferon-free directly acting antiviral (DAA) therapy, the impact of these improvements on patient adherence has not been described.MethodsMedication adherence was measured in 60 HCV, genotype-1, treatment-na?ve participants enrolled in a phase 2a clinical trial at the National Institutes of Health and community clinics. Participants received either ledipasvir/sofosbuvir (LDV/SOF) (90?mg/400?mg) (one pill) daily for 12?weeks, LDV/SOF?+?GS-9451 (80?mg/day) (two pills) daily for 6?weeks, or LDV/SOF?+?GS-9669 (500?mg twice daily; three pills, two in the morning, one in the evening) for 6?weeks. Adherence was measured using medication event monitoring system (MEMS) caps, pill counts and patient report.ResultsOverall adherence to DAAs was high. Adherence declined over the course of the 12-week treatment (p?=?0.04). While controlled psychiatric disease or symptoms of depression did not influence adherence, recent drug use was a risk factor for non-adherence to 12-week (p?=?0.01), but not 6-week regimens. Adherence as measured by MEMS was lower than by patient report.ConclusionsAdherence to short courses of DAA therapy with 1–3 pills a day was excellent in an urban population with multiple risk factors for non-adherence.