Milošević, Ivana (58456808200)Ivana (58456808200)MiloševićBeronja, Branko (58610945200)Branko (58610945200)BeronjaFilipović, Ana (58487006900)Ana (58487006900)FilipovićMitrović, Nikola (55110096400)Nikola (55110096400)MitrovićSimić, Jelena (57201274633)Jelena (57201274633)SimićKnežević, Nataša (59170791600)Nataša (59170791600)KneževićRanin, Jovana (57219407010)Jovana (57219407010)RaninTodorović, Nevena (58688792000)Nevena (58688792000)TodorovićStevanović, Olja (57201195181)Olja (57201195181)StevanovićRadovanović-Spurnić, Aleksandra (57191847101)Aleksandra (57191847101)Radovanović-SpurnićKatanić, Nataša (57190964860)Nataša (57190964860)KatanićHristović, Dejan (7801380935)Dejan (7801380935)HristovićNikolić, Nataša (58288723700)Nataša (58288723700)Nikolić2025-06-122025-06-122024https://doi.org/10.3390/microorganisms12122554https://www.scopus.com/inward/record.uri?eid=2-s2.0-85213260501&doi=10.3390%2fmicroorganisms12122554&partnerID=40&md5=8a78fcc5daeec99cac5fc983dbca745bhttps://remedy.med.bg.ac.rs/handle/123456789/785People who inject drugs (PWIDs) experience high rates of hepatitis C virus (HCV) infection, primarily due to needle sharing and limited healthcare access, resulting in a disproportionate disease burden within this population. This prospective study evaluated treatment outcomes in 432 adult patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs) at the University Clinical Center of Serbia. Patients were categorized into two groups based on a history of drug addiction: PWIDs (163, 37.7%) and non-PWIDs (269, 62.3%). The PWID group was further categorized into subpopulations of problematic PWIDs (39, 23.9%), ex-PWIDs (124, 76.1%), and PWIDs on OST (96, 58.9%). The PWID group demonstrated significantly lower treatment adherence, with an intention-to-treat (ITT) rate of 82.8%, compared to 96.3% in the control group (p < 0.001). In contrast, no significant differences were observed in per-protocol (PP) outcomes between the two groups. Additionally, PWIDs were significantly younger (p < 0.001) and had higher rates of psychiatric disorders (p < 0.001), alcohol abuse (p < 0.001), and HCV genotype 1a (p < 0.001). Advanced fibrosis was predictor of PP treatment failure among PWIDs, while mood disorders and alcohol use disorder were associated with interruptions before the scheduled completion time. For non-PWIDs, older age and advanced fibrosis emerged as key predictors of PP treatment failure. The loss to follow-up was most commonly observed in the problematic PWID subgroup (p = 0.001). These findings highlight the importance of addressing barriers in PWIDs through integrated care strategies that concurrently manage addiction and HCV. © 2024 by the authors.chronic hepatitis Cfollow-uppeople who inject drugsPWIDSVR12