Kate Mason|Zoë Dodd|Mary Guyton|Paula Tookey|Bernadette Lettner|John Matelski|Sanjeev Sockalingam|Jason Altenberg|Jeff Powis
Understanding real-world adherence in the directly acting antiviral era: A prospective evaluation of adherence among people with a history of drug use at a community-based program in Toronto, Canada
Regent Park Community Health Centre|Regent Park Community Health Centre|Regent Park Community Health Centre|Regent Park Community Health Centre|University Health Network|University Health Network|University of Toronto|Regent Park Community Health Centre|Toronto East General Hospital
direct acting antiviral daa treatments hepatitis c hcv widely available sustained virologic response svr rates 90 major predictor response daas adherence yet realworld studies evaluating adherence among marginalized people use drugs andor alcohol exist study evaluates patterns factors associated nonadherence among marginalized people history drug use receiving care primary care communitybased hcv treatment program opiate substitution offered onsiteprospective evaluation chronic hcv patients initiating daa treatment selfreport medication adherence questionnaires completed weekly prepost treatment questionnaires examined sociodemographics program engagement substance use missing adherence data counted missed doseof 74 participants initiated treatment 76 male average age 54 years 69 reported income disability benefits 30 stable housing 24 received opiate substitution therapy substance use common month prior treatment initiation 11 reported injection drug use 30 reported noninjection drug use 18 moderate heavy alcohol use majority 85 treatment nave 76 receiving sofosbuvirledipasvir 824 weeks 22 sofosbuvirribarvin 1224 weeks intention treat proportion svr12 87 6069 modified itt analysis excluding undetectable rna end treatment 91 6066 achieved svr12 overall 89 treatment weeks missed doses 41 participants least one missed dose multivariate analysis factor independently associated weeks missed doses moderate heavy alcohol use p005this study demonstrates strong adherence svr daas achievable appropriate supports even context substance use complex healthsocial issues