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. 2021 Mar;28(3):548-557.
doi: 10.1111/jvh.13445. Epub 2020 Dec 9.

Rates of perfect self-reported adherence to direct-acting antiviral therapy and its correlates among people who inject drugs on medications for opioid use disorder: The PREVAIL study

Irene Pericot-Valverde  1   2 , Lior Rennert  3 , Moonseong Heo  3 , Matthew J Akiyama  4 , Briana L Norton  4 , Linda Agyemang  4 , Brandon Lumsden  3 , Alain H Litwin  1   2   5
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Rates of perfect self-reported adherence to direct-acting antiviral therapy and its correlates among people who inject drugs on medications for opioid use disorder: The PREVAIL study

Irene Pericot-Valverde et al. J Viral Hepat. 2021 Mar.

Abstract

Adequate adherence to direct-acting antivirals (DAAs) for hepatitis C virus (HCV) is critical to attaining sustained virologic response (SVR). In this PREVAIL study's secondary analyses, we explored the association between self-reported and objective DAAs adherence among a sample of people who inject drugs (PWID) receiving medications for opioid use disorder (MOUD) (N = 147). Self-reported adherence was recoded 3 times during treatment (weeks 4, 8 and 12) using a visual analog scale (VAS), whereas objective adherence was collected continuously during treatment using electronic blister packs. Participants who reported being perfectly adherent had significantly higher blister pack adherence in each period (weeks 4, 8 and 12; ps < .05) and over the 12-week study (p < .001) compared to those who reported being non-perfectly adherent. Whites were more likely to report perfect adherence (91.7%) than Blacks (48.7%), Latinos (52.2%) and other (75.0%) race groups. Participants who reported recent use of cocaine (63.9%) or polysubstance use (60.0%) and those who had a positive result for cocaine (62.8%) were more likely to be non-perfectly adherent, although none of these factors were associated with blister pack adherence. This study showed that the VAS could serve as a reliable option for assessing DAAs adherence among PWID on MOUD. The implementation of VAS may be an ideal option for monitoring adherence among PWID on MOUD, especially in clinical settings with limited resources. PWID on MOUD who are Black or other races than White, as well as those who report recent cocaine or polysubstance use may require additional support to maintain optimal DAA adherence.

Keywords: direct-acting antiviral; hepatitis C virus; medications for opioid use disorder; people who inject drugs; self-reported Adherence.

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Figures

FIGURE 1
FIGURE 1
Patient self-reported adherence compared with blister pack data
FIGURE 2
FIGURE 2
Blister pack adherence as a function of perfect vs non-perfect self-reported adherence. Perfect and non-perfect groups significantly different at all treatment weeks (week 4: P=.004; week 8: P =.031; week 12: P =.021)
See this image and copyright information in PMC

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