Long-acting treatments may play a role in eradication of HCV
A cross-sectional survey of patients with or at risk for hepatitis C virus (HCV) found a high acceptability of long-acting treatments such as injections or implants, although daily oral medications were preferred by most. The authors noted that long-acting treatments might contribute to global efforts to eliminate HCV infection.
Patients who have or are at risk for hepatitis C virus (HCV) infection may be willing to tolerate long-acting treatments, according to a recent study.
Researchers performed a cross-sectional 43-question survey at 28 sites in nine countries to compare patients' interest in various long-acting treatment strategies (injection, implant, or gastric resident drug delivery system) versus oral medications (one to three pills taken daily for eight to 12 weeks). Those surveyed had HCV or were at high risk for HCV infection. The study results were published Oct. 26 by Clinical Infectious Diseases.
A total of 1,457 patients were included in the study. Of these, 1,140 (78.2%) were HCV positive, 64.7% were Black, and 71.1% were male. The median age was 55 years. Most patients had a history of injection drug use (82.1%) and were taking oral medications for a condition other than HCV (73.7%).
Of the HCV-positive patients, 37.7% said they would most prefer an injection, 5.6% an implant, and 6% a gastric residence device, while 50.8% said they would most prefer taking one to three pills per day. When HCV-positive patients were asked which treatment they would least prefer, 9.7% said an injection, 37.3% said an implant, and 48.4% said a gastric residence device, while 4.6% said pills. When an injection was compared directly to taking pills, relative preference for the former differed based on age (P<0.001), location (P<0.001), and previous receipt of HCV treatment (P=0.005) but did not differ by sex. Women (P=0.01) and younger adults (P=0.012 per five years) were more likely to prefer an implant to pills in direct comparisons.
Among the 309 at-risk patients without HCV, 34.7% preferred injections and 54% preferred pills in direct comparisons. Of the HCV-negative patients, 137 had received injectable medications previously, and in this group, 123 (89.8%) said they would be willing to receive them in the future. Forty-five patients (15.5%) preferred implants to pills while 123 (38.8%) said they would be willing to try an implant, and 202 patients (63.7%) said they preferred pills to a gastric residence device.
The authors noted that their study did not include many younger patients with new HCV infection and that most of the study participants were from three sites in Baltimore, among other limitations. They concluded that their results indicate high acceptability of long-acting HCV treatments among most patients with or at high risk for HCV, with some preferring such treatments to oral medications. “Clearly the next steps are to produce safe, affordable and effective approaches to provide these options to the 58 million persons who remain HCV infected,” the authors wrote.