Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya

Matthew Akiyama; Lindsey Riback; Mercy Nyakowa; Helgar Musyoki; John Lizcano; Abbe Muller; Chenshu Zhang; Josephine G Walker; Jack Stone; Peter T Vickerman; Peter Cherutich; Ann Kurth

doi:10.1111/jvh.13662

Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya

Matthew Akiyama^*, Lindsey Riback, Mercy Nyakowa, Helgar Musyoki, John Lizcano, Abbe Muller, Chenshu Zhang, Josephine G Walker, Jack Stone, Peter T Vickerman, Peter Cherutich, Ann Kurth

^*Corresponding author for this work

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Abstract

Background: Data are limited on HCV treatment outcomes among people who inject drugs (PWID) in low- and middle-income countries (LMICs) and particularly sub-Saharan Africa.

Methods: We provided ledipasvir/sofosbuvir under directly observed therapy (DOT) to 95 PWID accessing medication-assisted treatment (MAT) and needle and syringe programs (NSP) in Nairobi and Coastal Kenya.

Results: Participants were predominantly male (n=81, 85.3%), mean age of 36.5 years (SD=±6.5); 38 (40%) were HIV-positive, 12 (12.6%) were cirrhotic, and 87 (91.6%) reported injecting drugs in the last 30 days. Genotypes were 53 (55.8%) 1a, 39 (41.1%) 4a, and 3 (3.2%) 1a/4a. Among 92 who initiated treatment, 85 (92.4%) completed treatment and 79 (85.9%) achieved SVR.
Conclusions: HCV treatment among PWID in an LMIC setting is feasible. Further research is necessary to ascertain optimal models of HCV care given NSP and MAT access is variable in LMICs, and DOT may not be sustainable with limited resources.

Original language	English
Pages (from-to)	691-694
Number of pages	4
Journal	Journal of Viral Hepatitis
Volume	29
Issue number	8
Early online date	11 Mar 2022
DOIs	https://doi.org/10.1111/jvh.13662
Publication status	E-pub ahead of print - 11 Mar 2022

Bibliographical note

Funding Information:
The project described was supported by the Grant Number R01DA032080 and R01DA032080-05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080-05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support.

Funding Information:
The project described was supported by the Grant Number R01DA032080 and R01DA032080‐05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.

Funding Information:
This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080‐05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support.

Keywords

HCV
PWID
DAA
Africa
LMIC

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jvh.13662

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Akiyama, M., Riback, L., Nyakowa, M., Musyoki, H., Lizcano, J., Muller, A., Zhang, C., Walker, J. G., Stone, J., Vickerman, P. T., Cherutich, P., & Kurth, A. (2022). Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya. Journal of Viral Hepatitis, 29(8), 691-694. Advance online publication. https://doi.org/10.1111/jvh.13662

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title = "Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya",

abstract = "Background: Data are limited on HCV treatment outcomes among people who inject drugs (PWID) in low- and middle-income countries (LMICs) and particularly sub-Saharan Africa.Methods: We provided ledipasvir/sofosbuvir under directly observed therapy (DOT) to 95 PWID accessing medication-assisted treatment (MAT) and needle and syringe programs (NSP) in Nairobi and Coastal Kenya. Results: Participants were predominantly male (n=81, 85.3%), mean age of 36.5 years (SD=±6.5); 38 (40%) were HIV-positive, 12 (12.6%) were cirrhotic, and 87 (91.6%) reported injecting drugs in the last 30 days. Genotypes were 53 (55.8%) 1a, 39 (41.1%) 4a, and 3 (3.2%) 1a/4a. Among 92 who initiated treatment, 85 (92.4%) completed treatment and 79 (85.9%) achieved SVR. Conclusions: HCV treatment among PWID in an LMIC setting is feasible. Further research is necessary to ascertain optimal models of HCV care given NSP and MAT access is variable in LMICs, and DOT may not be sustainable with limited resources. ",

keywords = "HCV, PWID, DAA, Africa, LMIC",

author = "Matthew Akiyama and Lindsey Riback and Mercy Nyakowa and Helgar Musyoki and John Lizcano and Abbe Muller and Chenshu Zhang and Walker, {Josephine G} and Jack Stone and Vickerman, {Peter T} and Peter Cherutich and Ann Kurth",

note = "Funding Information: The project described was supported by the Grant Number R01DA032080 and R01DA032080-05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080-05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support. Funding Information: The project described was supported by the Grant Number R01DA032080 and R01DA032080‐05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. Funding Information: This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080‐05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support.",

year = "2022",

month = mar,

day = "11",

doi = "10.1111/jvh.13662",

language = "English",

volume = "29",

pages = "691--694",

journal = "Journal of Viral Hepatitis",

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TY - JOUR

T1 - Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya

AU - Akiyama, Matthew

AU - Riback, Lindsey

AU - Nyakowa, Mercy

AU - Musyoki, Helgar

AU - Lizcano, John

AU - Muller, Abbe

AU - Zhang, Chenshu

AU - Walker, Josephine G

AU - Stone, Jack

AU - Vickerman, Peter T

AU - Cherutich, Peter

AU - Kurth, Ann

N1 - Funding Information: The project described was supported by the Grant Number R01DA032080 and R01DA032080-05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080-05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support. Funding Information: The project described was supported by the Grant Number R01DA032080 and R01DA032080‐05S1 from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. Funding Information: This research was supported by the National Institute On Drug Abuse (NIDA) of the National Institutes of Health (NIH) under Award Number R01DA032080 and a pilot grant from the Albert Einstein Global Health Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project was supported by grants (numbers R01DA032080 and R01DA032080‐05S1, awarded to principal investigators AEK and PC) from the National Institute on Drug Abuse (NIDA). Dr. Akiyama is also supported by grants from NIDA R00 DA043011, DP2 DA053730, and the National Institute on Minority Health and Health Disparities (NIMHD) R01MD016744. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. We gratefully acknowledge the Centers for Disease Control and Prevention, Division of Viral Hepatitis (Atlanta, GA, USA) for assistance in genotyping the specimens obtained in this study; Kenya National Blood Transfusion Services (Nairobi, Mombasa, Malindi, and Kisumu, Kenya) for assistance in plasma separation; and the Kenya Medical Research Institute (Kisumu, Kenya) for assistance with HCV RNA confirmatory tests. We also thank Martin Sirengo, Janet Muriithi, Emily Juma, and the research assistants at the National AIDS & STI Control Program for their contributions and support, as well as National Institute on Drug Abuse Project Officer Dionne Jones for her continuing support.

PY - 2022/3/11

Y1 - 2022/3/11

N2 - Background: Data are limited on HCV treatment outcomes among people who inject drugs (PWID) in low- and middle-income countries (LMICs) and particularly sub-Saharan Africa.Methods: We provided ledipasvir/sofosbuvir under directly observed therapy (DOT) to 95 PWID accessing medication-assisted treatment (MAT) and needle and syringe programs (NSP) in Nairobi and Coastal Kenya. Results: Participants were predominantly male (n=81, 85.3%), mean age of 36.5 years (SD=±6.5); 38 (40%) were HIV-positive, 12 (12.6%) were cirrhotic, and 87 (91.6%) reported injecting drugs in the last 30 days. Genotypes were 53 (55.8%) 1a, 39 (41.1%) 4a, and 3 (3.2%) 1a/4a. Among 92 who initiated treatment, 85 (92.4%) completed treatment and 79 (85.9%) achieved SVR. Conclusions: HCV treatment among PWID in an LMIC setting is feasible. Further research is necessary to ascertain optimal models of HCV care given NSP and MAT access is variable in LMICs, and DOT may not be sustainable with limited resources.

AB - Background: Data are limited on HCV treatment outcomes among people who inject drugs (PWID) in low- and middle-income countries (LMICs) and particularly sub-Saharan Africa.Methods: We provided ledipasvir/sofosbuvir under directly observed therapy (DOT) to 95 PWID accessing medication-assisted treatment (MAT) and needle and syringe programs (NSP) in Nairobi and Coastal Kenya. Results: Participants were predominantly male (n=81, 85.3%), mean age of 36.5 years (SD=±6.5); 38 (40%) were HIV-positive, 12 (12.6%) were cirrhotic, and 87 (91.6%) reported injecting drugs in the last 30 days. Genotypes were 53 (55.8%) 1a, 39 (41.1%) 4a, and 3 (3.2%) 1a/4a. Among 92 who initiated treatment, 85 (92.4%) completed treatment and 79 (85.9%) achieved SVR. Conclusions: HCV treatment among PWID in an LMIC setting is feasible. Further research is necessary to ascertain optimal models of HCV care given NSP and MAT access is variable in LMICs, and DOT may not be sustainable with limited resources.

KW - HCV

KW - PWID

KW - DAA

KW - Africa

KW - LMIC

U2 - 10.1111/jvh.13662

DO - 10.1111/jvh.13662

M3 - Article (Academic Journal)

C2 - 35274394

SN - 1352-0504

VL - 29

SP - 691

EP - 694

JO - Journal of Viral Hepatitis

JF - Journal of Viral Hepatitis

IS - 8

ER -

Hepatitis C Treatment Outcomes Among People Who Inject Drugs Accessing Harm Reduction Settings in Kenya

Abstract

Bibliographical note

Keywords

UN SDGs

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