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Townshend-Bulson L, Roik E, Barbour Y, Bruden DJT, Homan CE, Espera HGF, Stevenson TJ, Hewitt AM, Rhodes W, Gove JE, Plotnik JN, Snowball MM, McGilvray J, Simons BC, Johnston JM, McMahon BJ. The Alaska Native/American Indian experience of hepatitis C treatment with sofosbuvir-based direct-acting antivirals. PLoS One 2021; 16:e0260970. [PMID: 34855920 PMCID: PMC8639063 DOI: 10.1371/journal.pone.0260970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/20/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Direct-acting antiviral (DAA) drugs have been effective in the treatment of chronic hepatitis C virus (HCV) infection. Limited data are available on safety, tolerability, and efficacy in American Indian or Alaska Native people. We aim to evaluate the treatment outcomes of sofosbuvir- based regimens for treatment of HCV in a real life setting in Alaska Native/American Indian (AN/AI) people. METHODS AN/AI patients within the Alaska Tribal Health System with confirmed positive anti-HCV and HCV RNA, who were 18 years of age and older were included in the study. Pretreatment baseline patient characteristics, treatment efficacy based on sustained virologic response (SVR) 12 weeks after treatment completion, and adverse effects were assessed. The following treatments were given according to the American Association for the Study of Liver Diseases/Infectious Disease Society of America (AASLD/IDSA) HCV Guidance: ledipasvir/sofosbuvir, sofosbuvir plus weight-based ribavirin, and sofosbuvir/velpatasvir. RESULTS We included 501 patients with a mean age of 54.3 (range 21.3-78.3) in the study. Overall SVR was achieved in 95.2% of patients who received one of the three DAA regimens. For those with cirrhosis, overall SVR was 92.8% and for those with genotype 3 91.1% achieved SVR. The most common symptom experienced during treatment was headache. Joint pain was found to decrease during treatment. One person discontinued sofosbuvir plus ribavirin due to myocardial infarction and one discontinued sofosbuvir/velpatasvir due to urticaria. CONCLUSIONS In the real-world setting, sofosbuvir-based treatment is safe, effective, and well tolerated in AN/AI patients. Sustained virologic response was high regardless of HCV genotype or cirrhosis status.
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Affiliation(s)
- Lisa Townshend-Bulson
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Elena Roik
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Youssef Barbour
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Dana J. T. Bruden
- Centers for Disease Control and Prevention, Anchorage, Alaska, United States of America
| | - Chriss E. Homan
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Hannah G. F. Espera
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | | | - Annette M. Hewitt
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Wileina Rhodes
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - James E. Gove
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Julia N. Plotnik
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Mary M. Snowball
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - John McGilvray
- Pharmacy Department, Southcentral Foundation, Anchorage, Alaska, United States of America
| | - Brenna C. Simons
- Centers for Disease Control and Prevention, Anchorage, Alaska, United States of America
| | - Janet M. Johnston
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
| | - Brian J. McMahon
- Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis Program, Anchorage, Alaska, United States of America
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