High Efficiency and Safety of Hepatitis C Treatment Among People Who Inject Drugs in Vietnam

People who inject drugs (PWID) are highly affected by hepatitis C (HCV) worldwide, particularly in low- and middle-income countries (LMICs), where access to addiction services is often limited. Reducing the burden of HCV, as promoted by WHO, requires effective interventions in this high-risk population. Here, we report the safety and efficacy of a pangenotypic generic HCV treatment among PWID in Vietnam, using a sofosbuvir/daclatasvir regimen. PWID were screened for HCV at two community-based organisations (CBO) premises in Haiphong during both a respondent-driven sampling survey and cohort follow-up visits. PWID with detectable HCV RNA were referred to three public hospitals for a 12-week regimen of generic sofosbuvir/daclatasvir, with ribavirin if cirrhosis, and with CBO support for referral and adherence. Treatment safety was assessed over the course of treatment and success was measured by sustained virologic response 12 weeks after the end of treatment (SVR12). Of the 1201 PWID screened with detectable HCV RNA, 1021 were enrolled: 96% male, median age 42 years, 45% HIV-infected, 16% with advanced liver fibrosis, 55% currently injecting, and 71.5% on methadone maintenance therapy (MMT). In total, 979 participants started HCV treatment, and 901 of the 924 participants tested at SVR12 (98%) were cured. Genotype 3, current drug use, lack of MMT, and HIV infection were independently associated with treatment failure. High HCV cure rates can be achieved among PWID in LMICs such as Vietnam using a simple model of care, including a pangenotypic generic direct-acting antiviral combination and CBO support. Trial Registration: ClinicalTrials.gov identifier: NCT03537196.

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Publication Details

Journal
Journal of Viral Hepatitis
Published
2025-09-29
DOI
https://doi.org/10.1111/jvh.70090
Primary Topic
Hepatitis C virus research
Type
article
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article

High Efficiency and Safety of Hepatitis C Treatment Among People Who Inject Drugs in Vietnam

Delphine Rapoud, Nicolas Nagot, Dương Thị Hương, Khuat Thi Hai Oanh et al.
Journal of Viral Hepatitis
Hepatitis C virus research
article

High Efficiency and Safety of Hepatitis C Treatment Among People Who Inject Drugs in Vietnam

Delphine Rapoud, Nicolas Nagot, Dương Thị Hương, Khuat Thi Hai Oanh, Roselyne Vallo, Jean‐Pierre Molès, Vinh Vu Hai, Laurence Weiss, Hannah Fraser, Maud Lemoine, Nham Thi Tuyet Thanh, Peter Vickerman, Karine Lacombe, Phạm Minh Khuê, Bach Thi Nhu Quynh, Jonathan Feelemyer, Didier Laureillard, Laurent Michel, Catherine Quillet, Nguyễn Thanh Bình, Don Des Jarlais, Tran Thi Hong
article en

Abstract

People who inject drugs (PWID) are highly affected by hepatitis C (HCV) worldwide, particularly in low- and middle-income countries (LMICs), where access to addiction services is often limited. Reducing the burden of HCV, as promoted by WHO, requires effective interventions in this high-risk population. Here, we report the safety and efficacy of a pangenotypic generic HCV treatment among PWID in Vietnam, using a sofosbuvir/daclatasvir regimen. PWID were screened for HCV at two community-based organisations (CBO) premises in Haiphong during both a respondent-driven sampling survey and cohort follow-up visits. PWID with detectable HCV RNA were referred to three public hospitals for a 12-week regimen of generic sofosbuvir/daclatasvir, with ribavirin if cirrhosis, and with CBO support for referral and adherence. Treatment safety was assessed over the course of treatment and success was measured by sustained virologic response 12 weeks after the end of treatment (SVR12). Of the 1201 PWID screened with detectable HCV RNA, 1021 were enrolled: 96% male, median age 42 years, 45% HIV-infected, 16% with advanced liver fibrosis, 55% currently injecting, and 71.5% on methadone maintenance therapy (MMT). In total, 979 participants started HCV treatment, and 901 of the 924 participants tested at SVR12 (98%) were cured. Genotype 3, current drug use, lack of MMT, and HIV infection were independently associated with treatment failure. High HCV cure rates can be achieved among PWID in LMICs such as Vietnam using a simple model of care, including a pangenotypic generic direct-acting antiviral combination and CBO support. Trial Registration: ClinicalTrials.gov identifier: NCT03537196.

Journal of Viral HepatitisVol. 32(11)
Inserm (FR), Université de Montpellier (FR), Université Paris Cité (FR), Université Paris-Saclay (FR), Hai phong University Of Medicine and Pharmacy (VN), Hai Phong University (VN), University of Bristol (GB), Sorbonne Université (FR), Development Initiatives (GB), Centre de recherche en Epidémiologie et Santé des Populations (FR), Center for Digestive and Liver Diseases (US), Centre de Recherche Saint-Antoine (FR), Hung Vuong Hospital (VN), Hospital for Tropical Diseases (VN), Imperial College London (GB), New York University (US), Université de Nîmes (FR)
Openalex Percentile: Top 64%
Hepatitis C virus research
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