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Clinical pharmacy
CP-079 Relationship between adherence to hepatitis C treatment and rapid, early and sustained viral response
  1. L Santulario-Verdú1,
  2. M Comas-Sugranes1,
  3. E Van Den Eynde-Otero2,
  4. M Colls-González1,
  5. F Xiol-Quingles3,
  6. P Márquez-Rodríguez3,
  7. N Padullés-Zamora1
  1. 1Hospital Universitari de Bellvitge, Hospital Pharmacy Department, Barcelona, Spain
  2. 2Hospital Universitari de Bellvitge, HIV Department, Barcelona, Spain
  3. 3Hospital Universitari de Bellvitge, Gastroenterology and Hepatology Department, Barcelona, Spain

Abstract

Background The level of adherence to hepatitis C virus (HCV) treatment is associated with response. High adherence throughout the initial 12 weeks is related to better virological outcomes. Several factors can influence adherence.

Purpose To assess HCV treatment adherence and to evaluate the relationship between adherence and rapid (RVR), early (EVR) and sustained virological response (SVR).

Material and methods Retrospective observational study of HCV-infected patients receiving pegylated interferon (peg-IFN) + ribavirin (RBV) ± protease inhibitor (PI) from January 2011–December 2013. Demographic and clinical data recorded: age, sex, weight, HIV infection, HCV genotype; quantitative HCV RNA; peg-IFN, RBV and PI doses, frequency and quantities dispensed; psychiatric disorders.

Results 183 patients (31.1% women); 14.2% HIV co-infected; 71.2% genotype 1. IL28B CT/TT genotype rate: 33/46.

79.8% were treated with peg-INF + RBV and 20.2% with peg-INF + RBV + PI. 11.7% received reduced RBV/peg-IFN doses. 3.3% required growth factor.

RVR: 97.4% (mean reduction: 1.91 log IU/ml). EVR: 46.1%. SVR: 57.3% (genotype 1: 47.1% vs. others: 73.8%; p = 0.011). SVR among PI treated patients: 72.7%.

Overall adherence according to quantities dispensed and the Morisky-Green test were 97.35% (95.8% with >80% adherence) and 99.56% (100% > 85% adherence), respectively. Mean adherence according to quantities dispensed at 4 and 12 weeks was 100% and 99.8%, respectively.

Sex, HIV co-infection or psychiatric diseases were not associated with lower adherence.

No relationship was found between RVR and adherence but the EVR was found to be significantly greater with adherence levels >85% (11.1% vs. 48.3%). Adherence ≥80% was associated with (not significantly) higher rates of SVR (57.7% vs. 50%).

Conclusion Adherence >80% is associated with higher cure rates and adherence >85% at 12 weeks is related to greater EVR. No relationship was found between HCV-RNA decrease at 4 weeks and adherence. Neither psychiatric disorders nor HIV co-infection influenced adherence.

References and/or Acknowledgements

  1. Mathes T, Antoine SL, Pieper D. BMC Infectious Diseases 2014;14:203–16

  2. Lo Re V, Amorosa VK, Localio A, et al. Adherence to hepatitis C virus therapy in HIV/hepatitis C-Coinfected patients. CID 2009;48:186–93

References and/or AcknowledgementsNo conflict of interest.

https://doi.org/10.1136/ejhpharm-2015-000639.75

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