{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:44:18Z","timestamp":1783395858513,"version":"3.54.6"},"reference-count":55,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Liver Dis"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Although therapy with direct-acting antiviral (DAA) agents achieves high hepatitis C virus (HCV) cure rates and is forgiving of missed doses, certain patient populations, such as people who inject drugs (PWID), are often denied therapy because of a perceived high risk of nonadherence. However, a relationship between adherence to DAAs for various patient populations and efficacy has not been well defined. The lack of a standardized method for evaluating adherence complicates making comparisons between studies, making it difficult to develop and implement novel measures that may improve adherent behavior. Traditional methods for assessing adherence may overestimate medication adherence, while newer, technology-based methods may assist with accurately assessing and maintaining patient adherence to therapy. Data demonstrate that special populations of patients with HCV, such as PWID, can be successfully treated, with relatively high rates of sustained virologic response (SVR) despite less-than-optimal adherence. While rates of adherence, and subsequently SVR, can be improved, antiviral therapy should not be withheld because of fear of nonadherence. This article addresses medication adherence and forgiveness of DAA regimens, such as sofosbuvir\/velpatasvir and glecaprevir\/pibrentasvir, in different patient populations with HCV. Considerations in evaluating adherence in HCV therapy and available methods for assessing adherence are detailed.<\/jats:p>","DOI":"10.1055\/a-2313-0111","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T23:04:53Z","timestamp":1713999893000},"page":"258-271","source":"Crossref","is-referenced-by-count":6,"title":["Adherence in Hepatitis C Virus Treatment: What We Know"],"prefix":"10.1055","volume":"44","author":[{"given":"Steven L.","family":"Flamm","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases and Nutrition, Rush University Medical School, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Mangia","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Hepatology, Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"ref1","volume-title":"Global Health Sector Strategy on Viral Hepatitis 2016\u20132021","author":"World Health Organization","year":"2016"},{"key":"ref2","first-page":"4","volume-title":"WHO Guidelines (Approved by the Guidelines Review Committee)","year":"2018"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/14656566.2017.1282459","article-title":"A pangenotypic, single tablet regimen of sofosbuvir\/velpatasvir for the treatment of chronic hepatitis C infection","volume":"18","author":"I S Weisberg","year":"2017","journal-title":"Expert Opin Pharmacother"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.2147\/DDDT.S172512","article-title":"Glecaprevir\/pibrentasvir for the treatment of chronic hepatitis C: design, development, and place in therapy","volume":"13","author":"T G Cotter","year":"2019","journal-title":"Drug Des Devel Ther"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12954-021-00519-y","article-title":"Therapy of chronic hepatitis C in people who inject drugs: focus on adherence","volume":"18","author":"S Frankova","year":"2021","journal-title":"Harm Reduct J"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/j.1524-4733.2007.00213.x","article-title":"Medication compliance and persistence: terminology and definitions","volume":"11","author":"J A Cramer","year":"2008","journal-title":"Value Health"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1192\/apt.bp.106.003194","article-title":"Why don't patients take their medicine? Reasons and solutions in psychiatry","volume":"13","author":"A J Mitchell","year":"2018","journal-title":"Adv Psychiatr Treat"},{"key":"ref9","volume-title":"Concordance, Adherence and Compliance in Medicine Taking","author":"R Horne","year":"2005"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.amjms.2016.01.010","article-title":"Medication adherence: truth and consequences","volume":"351","author":"M T Brown","year":"2016","journal-title":"Am J Med Sci"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"e0209023","DOI":"10.1371\/journal.pone.0209023","article-title":"Acceptable medication non-adherence: a crowdsourcing study among French physicians for commonly prescribed medications","volume":"13","author":"S Sidorkiewicz","year":"2018","journal-title":"PLoS One"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1590\/1413-81232022274.06942021","article-title":"Factors associated with hepatitis C treatment adherence: an integrative review","volume":"27","author":"L T C\u00f4co","year":"2022","journal-title":"Cien Saude Colet"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"100647","DOI":"10.1016\/j.aohep.2021.100647","article-title":"Global real-world evidence of sofosbuvir\/velpatasvir (SOF\/VEL) as a highly effective treatment in underserved patient populations because of mental health disorders, incarceration or homelessness","volume":"27","author":"L Barrett","year":"2022","journal-title":"Ann Hepatol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2217\/fvl-2021-0266","article-title":"Real-world evidence of sofosbuvir\/velpatasvir as an effective and simple hepatitis C virus treatment and elimination tool in homeless populations","volume":"17","author":"B Conway","year":"2021","journal-title":"Future Virol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"419","DOI":"10.2217\/fvl-2022-0016","article-title":"Real-world effectiveness of sofosbuvir\/velpatasvir for the treatment of hepatitis C virus in prison settings","volume":"17","author":"S Rosati","year":"2022","journal-title":"Future Virol"},{"issue":"28","key":"ref16","doi-asserted-by":"crossref","first-page":"e4151","DOI":"10.1097\/MD.0000000000004151","article-title":"Adherence to treatment of chronic hepatitis C: from interferon containing regimens to interferon and ribavirin free regimens","volume":"95","author":"Z M Younossi","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"ofaa377","DOI":"10.1093\/ofid\/ofaa377","article-title":"Low adherence achieves high HCV cure rates among people who inject drugs treated with direct-acting antiviral agents","volume":"7","author":"B L Norton","year":"2020","journal-title":"Open Forum Infect Dis"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1007\/s13142-015-0315-2","article-title":"Self-report measures of medication adherence behavior: recommendations on optimal use","volume":"5","author":"M J Stirratt","year":"2015","journal-title":"Transl Behav Med"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.jhep.2023.12.020","article-title":"Optimal hepatitis C treatment adherence patterns and sustained virologic response among people who inject drugs: the HERO study","volume":"80","author":"M Heo","year":"2024","journal-title":"J Hepatol"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review","volume":"5","author":"L Degenhardt","year":"2017","journal-title":"Lancet Glob Health"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s00508-021-01868-1","article-title":"Challenges in hepatitis C elimination despite highly effective antiviral agents in patients with and without intravenous drug use","volume":"133","author":"S Bota","year":"2021","journal-title":"Wien Klin Wochenschr"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S2468-1253(17)30404-1","article-title":"Sofosbuvir and velpatasvir for hepatitis C virus infection in people with recent injection drug use (SIMPLIFY): an open-label, single-arm, phase 4, multicentre trial","volume":"3","author":"J Grebely","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"12","key":"ref24","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/S2468-1253(22)00275-8","article-title":"Patient-centred models of hepatitis C treatment for people who inject drugs: a multicentre, pragmatic randomised trial","volume":"7","author":"A H Litwin","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"03","key":"ref25","first-page":"58","article-title":"Comparison of the efficacies of direct-acting antiviral treatment for HCV infection in people who inject drugs and non-drug users","volume":"58","author":"J T Hsu","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.drugpo.2017.05.032","article-title":"Delivering direct acting antiviral therapy for hepatitis C to highly marginalised and current drug injecting populations in a targeted primary health care setting","volume":"47","author":"P Read","year":"2017","journal-title":"Int J Drug Policy"},{"issue":"12","key":"ref27","doi-asserted-by":"crossref","first-page":"100580","DOI":"10.1016\/j.jhepr.2022.100580","article-title":"HCV microelimination in harm reduction centres has benefits beyond HCV cure but is hampered by high reinfection rates","volume":"4","author":"S Lens","year":"2022","journal-title":"JHEP Rep"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.drugpo.2018.08.013","article-title":"Adherence to sofosbuvir and velpatasvir among people with chronic HCV infection and recent injection drug use: the SIMPLIFY study","volume":"62","author":"E B Cunningham","year":"2018","journal-title":"Int J Drug Policy"},{"issue":"07","key":"ref29","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1093\/cid\/ciz1089","article-title":"Adherence to once-daily and twice-daily direct-acting antiviral therapy for hepatitis C infection among people with recent injection drug use or current opioid agonist therapy","volume":"71","author":"E B Cunningham","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"10","key":"ref31","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1002\/ueg2.12156","article-title":"Increased hepatitis C virus screening, diagnosis and linkage to care rates among people who use drugs through a patient-centered program from Italy","volume":"9","author":"A Mangia","year":"2021","journal-title":"United European Gastroenterol J"},{"issue":"07","key":"ref32","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1093\/cid\/ciaa105","article-title":"Concurrent initiation of hepatitis C and opioid use disorder treatment in people who inject drugs","volume":"71","author":"E S Rosenthal","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"11","key":"ref33","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1093\/cid\/ciad034","article-title":"Perspectives on adherence from the ACTG 5360 MINMON trial: a minimum monitoring approach with 12 weeks of sofosbuvir\/selpatasvir in chronic hepatitis C treatment","volume":"76","author":"L A Sowah","year":"2023","journal-title":"Clin Infect Dis"},{"issue":"02","key":"ref34","first-page":"195","article-title":"Sofosbuvir-based regimens for chronic hepatitis C in a well-insured U.S. population: patient characteristics, treatment adherence, effectiveness, and health care costs, 2013\u20132015","volume":"25","author":"S Yin","year":"2019","journal-title":"J Manag Care Spec Pharm"},{"issue":"11","key":"ref36","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3390\/v14112493","article-title":"Global real-world evidence of sofosbuvir\/velpatasvir as a highly effective treatment and elimination tool in people with hepatitis C infection experiencing mental health disorders","volume":"14","author":"H Wedemeyer","year":"2022","journal-title":"Viruses"},{"issue":"08","key":"ref37","doi-asserted-by":"crossref","first-page":"3465","DOI":"10.1007\/s12325-023-02539-5","article-title":"Shorter duration hepatitis C virus treatment is associated with better persistence to prescription refills in people who inject drugs: a real-world study","volume":"40","author":"A Martinez","year":"2023","journal-title":"Adv Ther"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"2203","DOI":"10.1007\/s40121-021-00455-1","article-title":"Real-world outcomes in historically underserved patients with chronic hepatitis C infection treated with glecaprevir\/pibrentasvir","volume":"10","author":"A Aghemo","year":"2021","journal-title":"Infect Dis Ther"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"103407","DOI":"10.1016\/j.drugpo.2021.103407","article-title":"Hepatitis C treatment at a Swedish needle exchange program, a successful model of care - the ACTIONNE study","volume":"96","author":"M A Blom\u00e9","year":"2021","journal-title":"Int J Drug Policy"},{"issue":"04","key":"ref40","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/liv.14266","article-title":"Adherence to pan-genotypic glecaprevir\/pibrentasvir and efficacy in HCV-infected patients: a pooled analysis of clinical trials","volume":"40","author":"A Brown","year":"2020","journal-title":"Liver Int"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.drugalcdep.2018.11.007","article-title":"Glecaprevir\/pibrentasvir in patients with chronic HCV and recent drug use: an integrated analysis of 7 phase III studies","volume":"194","author":"G R Foster","year":"2019","journal-title":"Drug Alcohol Depend"},{"issue":"09","key":"ref43","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.14309\/ajg.0000000000001332","article-title":"High sustained virologic response rates of glecaprevir\/pibrentasvir in patients with dosing interruption or suboptimal adherence","volume":"116","author":"P J Zamor","year":"2021","journal-title":"Am J Gastroenterol"},{"issue":"04","key":"ref44","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/HC9.0000000000000125","article-title":"Increasing national trend of direct-acting antiviral discontinuation among people treated for HCV 2016-2021","volume":"7","author":"J Carson","year":"2023","journal-title":"Hepatol Commun"},{"issue":"11","key":"ref45","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1093\/cid\/ciab334","article-title":"Hepatitis C virus direct-acting antiviral treatment adherence patterns and sustained viral response among people who inject drugs treated in opioid agonist therapy programs","volume":"73","author":"M Heo","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1056\/NEJMra050100","article-title":"Adherence to medication","volume":"353","author":"L Osterberg","year":"2005","journal-title":"N Engl J Med"},{"issue":"04","key":"ref47","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S2468-1253(21)00397-6","article-title":"A minimal monitoring approach for the treatment of hepatitis C virus infection (ACTG A5360 [MINMON]): a phase 4, open-label, single-arm trial","volume":"7","author":"S S Solomon","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"06","key":"ref48","doi-asserted-by":"crossref","first-page":"353","DOI":"10.7326\/0003-4819-155-6-201109200-00003","article-title":"Relationship between adherence to hepatitis C virus therapy and virologic outcomes: a cohort study","volume":"155","author":"V Lo Re III","year":"2011","journal-title":"Ann Intern Med"},{"issue":"04","key":"ref49","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s11606-019-05394-9","article-title":"Medication non-adherence in a prospective, multi-center cohort treated with hepatitis C direct-acting antivirals","volume":"35","author":"M Serper","year":"2020","journal-title":"J Gen Intern Med"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.phrs.2017.08.015","article-title":"Drug adherence in hypertension","volume":"125","author":"M Burnier","year":"2017","journal-title":"Pharmacol Res"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"625","DOI":"10.7326\/M16-0816","article-title":"Elbasvir-grazoprevir to treat hepatitis C virus infection in persons receiving opioid agonist therapy: a randomized trial","volume":"165","author":"G J Dore","year":"2016","journal-title":"Ann Intern Med"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1007\/s12072-015-9680-7","article-title":"High adherence to all-oral directly acting antiviral HCV therapy among an inner-city patient population in a phase 2a study","volume":"10","author":"T Petersen","year":"2016","journal-title":"Hepatol Int"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"594","DOI":"10.7326\/M18-1715","article-title":"Intensive models of hepatitis C care for people who inject drugs receiving opioid agonist therapy: a randomized controlled trial","volume":"170","author":"M J Akiyama","year":"2019","journal-title":"Ann Intern Med"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"e0217471","DOI":"10.1371\/journal.pone.0217471","article-title":"Randomized feasibility trial of directly observed versus unobserved hepatitis C treatment with ledipasvir-sofosbuvir among people who inject drugs","volume":"14","author":"P O Coffin","year":"2019","journal-title":"PLoS ONE"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"ofaa564","DOI":"10.1093\/ofid\/ofaa564","article-title":"Adherence to direct-acting antiviral therapy in people actively using drugs and alcohol: the INCLUD study","volume":"8","author":"K M Brooks","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"ofaa290","DOI":"10.1093\/ofid\/ofaa290","article-title":"Artificial intelligence platform demonstrates high adherence in patients receiving fixed-dose ledipasvir and sofosbuvir: a pilot study","volume":"7","author":"A H Litwin","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1111\/apt.15707","article-title":"Impact of a digital medicine programme on hepatitis C treatment adherence and efficacy in adults at high risk for non-adherence","volume":"51","author":"M Sulkowski","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"ref60","doi-asserted-by":"crossref","first-page":"e15532","DOI":"10.2196\/15532","article-title":"Wirelessly observed therapy to optimize adherence and target interventions for oral hepatitis C treatment: observational pilot study","volume":"22","author":"M Bonacini","year":"2020","journal-title":"J Med Internet Res"},{"issue":"02","key":"ref62","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/jvh.13897","article-title":"Excellent hepatitis C virus cure rates despite increasing complexity of people who use drugs: Integrated-Test-stage Treat study final outcomes","volume":"31","author":"M O'Sullivan","year":"2024","journal-title":"J Viral Hepat"},{"issue":"03","key":"ref63","first-page":"312","article-title":"Association between direct-acting agents adherence and health-related quality of life of patients with hepatitis C","volume":"49","author":"I P Doica","year":"2023","journal-title":"Curr Health Sci J"}],"container-title":["Seminars in Liver Disease"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2313-0111.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:52:55Z","timestamp":1730803975000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2313-0111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,24]]},"references-count":55,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,7,12]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2313-0111","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0272-8087","1098-8971"],"issn-type":[{"value":"0272-8087","type":"print"},{"value":"1098-8971","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,24]]},"published":{"date-parts":[[2024,4,24]]}}}