# Injecting Drug Use History and Younger Age Worsen Adherence to Scheduled Hospital Visits in Glecaprevir and Pibrentasvir Therapy for Chronic Hepatitis C

## TL;DR

Younger patients and those with a history of drug use are less likely to stick to hospital visits during hepatitis C treatment.

## Contribution

Identifies drug use history and younger age as novel risk factors for poor adherence in hepatitis C therapy.

## Key findings

- 13% of patients had a history of injecting drug use, which was linked to poor adherence.
- Patients younger than 60 were three times more likely to discontinue hospital visits.
- The sustained viral response rate was 96.8% among patients who completed treatment.

## Abstract

The use of direct‐acting antivirals (DAAs) against the Hepatitis C virus (HCV) has rapidly expanded since their introduction. However, some patients with HCV infection may still not receive appropriate medical care. This study analyzed the characteristics and adherence of the population receiving therapy with two later‐generation DAAs, glecaprevir (GLE) and pibrentasvir (PIB), to investigate the clinical challenges associated with HCV treatment.

A total of 141 consecutive patients who underwent GLE/PIB therapy for chronic HCV infection between December 2017 and June 2021 were enrolled. Patient backgrounds and adherence were retrospectively analyzed.

Median patient age was 61 years. Eighteen patients had a history of injecting drug use (IDU), accounting for 13% of the sample. At the end of treatment, three patients (2.1%) self‐discontinued hospital visits. The number of patients who self‐discontinued hospital visits gradually increased over time to 9 (6.4%) at 4 weeks after treatment, 16 (11.3%) at 12 weeks after treatment, and 24 (17.0%) at 24 weeks after treatment. The sustained viral response rate after 12 weeks, excluding patients who self‐discontinued hospital visits, was 96.8% (121/125). In a multivariate analysis, age < 60 years and a history of IDU were significant factors associated with the self‐discontinuation of hospital visits. The hazard ratio (HR) for those younger than 60 years old was 3.17 (p = 0.012), whereas the HR for those with a history of IDU was 2.41 (p = 0.036).

History of IDU and younger age were significantly associated with poor adherence to GLE/PIB treatment.