Aud L Krook1, Dorthe Stokka, Bernt Heger, Egil Nygaard. 1. Unit for Addiction Medicine, Institute of Psychiatry, University of Oslo, and Clinic of Abuse and Dependence, Aker University Hospital HF, Oslo, Norway. aud.krook@gmail.com
Abstract
BACKGROUND: Many physicians are still skeptic to treat opioid dependants, with or without maintenance treatment, for hepatitis C (HCV) because of concerns about psychiatric comorbidity, stability and adherence. In Norway, there are about 3,500 patients participating in the restrictive medication-assisted rehabilitation (LAR) programs in which all patients are given methadone or buprenorphine maintenance therapy. This study was undertaken to determine whether HCV combination therapy with pegylated interferon alpha-2a plus ribavirin is feasible, efficient and safe in this patient group. METHOD: Seventeen patients with HCV genotype 3a were treated for 24 weeks. To optimize compliance, the treatment was given from a department of infectious diseases in cooperation with an LAR center. All injections were given in the LAR center and the patients were given psychosocial support. RESULTS: The compliance was 100%. All responded to the therapy and 16 (94%) were sustained responders. DISCUSSION/ CONCLUSION: This study indicates that compliance and treatment outcome of opioid dependants on methadone or buprenorphine maintenance after 24 weeks of HCV treatment corresponds to that for non-dependants if extra support is given. The treatment should be undertaken in collaboration with specialists in addiction medicine, hepatology and infectious diseases.
BACKGROUND: Many physicians are still skeptic to treat opioid dependants, with or without maintenance treatment, for hepatitis C (HCV) because of concerns about psychiatric comorbidity, stability and adherence. In Norway, there are about 3,500 patients participating in the restrictive medication-assisted rehabilitation (LAR) programs in which all patients are given methadone or buprenorphine maintenance therapy. This study was undertaken to determine whether HCV combination therapy with pegylated interferon alpha-2a plus ribavirin is feasible, efficient and safe in this patient group. METHOD: Seventeen patients with HCV genotype 3a were treated for 24 weeks. To optimize compliance, the treatment was given from a department of infectious diseases in cooperation with an LAR center. All injections were given in the LAR center and the patients were given psychosocial support. RESULTS: The compliance was 100%. All responded to the therapy and 16 (94%) were sustained responders. DISCUSSION/ CONCLUSION: This study indicates that compliance and treatment outcome of opioid dependants on methadone or buprenorphine maintenance after 24 weeks of HCV treatment corresponds to that for non-dependants if extra support is given. The treatment should be undertaken in collaboration with specialists in addiction medicine, hepatology and infectious diseases.
Authors: Thomas F Kresina; Diana Sylvestre; Leonard Seeff; Alain H Litwin; Kenneth Hoffman; Robert Lubran; H Westley Clark Journal: Subst Abuse Date: 2008-04-28
Authors: K Neukam; J A Mira; I Gilabert; E Claro; M J Vázquez; C Cifuentes; S García-Rey; N Merchante; C Almeida; J Macías; J A Pineda Journal: Eur J Clin Microbiol Infect Dis Date: 2011-10-06 Impact factor: 3.267
Authors: Rositsa B Dimova; Marija Zeremski; Ira M Jacobson; Holly Hagan; Don C Des Jarlais; Andrew H Talal Journal: Clin Infect Dis Date: 2012-12-07 Impact factor: 9.079
Authors: Joseph Moussalli; Helene Delaquaize; Dominique Boubilley; Jean Pierre Lhomme; Jules Merleau Ponty; David Sabot; Anne Kerever; Marc Valleur; Thierry Poynard Journal: Gastroenterol Res Pract Date: 2010-07-18 Impact factor: 2.260
Authors: Marija Zeremski; Jon E Zibbell; Anthony D Martinez; Steven Kritz; Bryce D Smith; Andrew H Talal Journal: World J Gastroenterol Date: 2013-11-28 Impact factor: 5.742