F3. Hepatitis C
Oral Abstract Submission
Shyam Kottilil, MD PhD
Director Clinical Care and Research, ID Division Head
University of Maryland
Disclosure: Merck, Gilead: Advisor or Review Panel member
Merck, Gilead, Arbutus: Grant/Research Support
Background : Engaging PWID in HCV treatment and monitoring for reinfection is critical to eliminate HCV and improve health in people who use drugs. However, PWID are often marginalized and can be difficult to engage and retain in care. Collocation of HCV treatment with buprenorphine to treat opioid use disorder (OUD) may improve visit adherence in this population.
Methods : ANCHOR is a single-center study evaluating treatment of HCV in PWID with chronic HCV, OUD, and IDU. Participants receive sofosbuvir/velpatasvir x12 weeks and are offered collocated buprenorphine. HCV visits occur at weeks 4, 12, 24, 48, 72 and 96.
At screening, the 100 enrolled patients were predominantly male (76%), black (93%), middle-aged (median 57years), injected opioids daily or more (58%), and were not on OAT (67%). Fifty-five (55%) patients were initiated on collocated buprenorphine at some point after day 0.
Being on collocated buprenorphine at the time of HCV visit was associated with increased likelihood of visit attendance at weeks 12 (p=0.002), 24 (p=0.01), 48 (p=0.02), 72 (p=0.003), and 96 (p=0.04). For patients who attended study visits, being on collocated buprenorphine was associated with a shorter time between planned visit and actual visit at weeks 12 (p=0.03), 24 (p=0.04), and 48 (p=0.04). When looking at patients not on collocated buprenorphine, being on non-collocated opioid agonist therapy vs not being on OUD treatment did not impact visit adherence.
Evidence based treatment of HCV and OUD are critical to improving health in PWID. Collocation of HCV treatment with office-based buprenorphine may improve adherence to visits and visit timing, especially in long-term follow-up. Infectious disease providers should offer collocated buprenorphine as a tool to improve long-term outcomes and engagement in this high-risk population.