OBJECTIVE: The purpose of this study was to explore changes in transaminase values associated with buprenorphine treatment and hepatitis C status among opioid dependent subjects aged 15-21. METHODS:152 subjects seeking treatment for opioid dependence were randomized to 2-week detoxification with buprenorphine/naloxone (DETOX) or 12 weeks buprenorphine/naloxone (BUP). Liver chemistries including transaminases were obtained baseline and at 4, 8, and 12 weeks. 111 patients had at least one set of transaminases during treatment and were included in analyses of treatment effects. RESULTS: Overall, 8/60 BUP participants vs. 12/51 DETOX participants had at least one elevated ALT value during follow-up (Chi-square n.s.). 5/60 BUP participants vs. 11/51 DETOX participants had at least one elevated AST value (Chi-square = 3.194, p = .048). Twenty-eight out of 152 participants were hepatitis C (HCV) positive at baseline, and 4 seroconverted within 12 weeks, 2 in each group. HCV status was significantly associated with transaminase abnormalities (p = .009 and p = .006 for ALT an AST, respectively). HCV status had a strong effect on transaminase abnormalities among participants assigned to DETOX, but not among those assigned to BUP. CONCLUSIONS: No evidence was found for hepatotoxicity of buprenorphine in this exploratory analysis. HCV was present in a significant minority of participants and was a significant predictor of transaminase elevation. Results suggest that stabilization on buprenorphine may decrease the frequency of transaminase abnormalities associated with HCV in opioid dependent young people. The high rate of seroconversion underscores the importance of effective treatment and prevention.
RCT Entities:
OBJECTIVE: The purpose of this study was to explore changes in transaminase values associated with buprenorphine treatment and hepatitis C status among opioid dependent subjects aged 15-21. METHODS: 152 subjects seeking treatment for opioid dependence were randomized to 2-week detoxification with buprenorphine/naloxone (DETOX) or 12 weeks buprenorphine/naloxone (BUP). Liver chemistries including transaminases were obtained baseline and at 4, 8, and 12 weeks. 111 patients had at least one set of transaminases during treatment and were included in analyses of treatment effects. RESULTS: Overall, 8/60 BUPparticipants vs. 12/51 DETOXparticipants had at least one elevated ALT value during follow-up (Chi-square n.s.). 5/60 BUPparticipants vs. 11/51 DETOXparticipants had at least one elevated AST value (Chi-square = 3.194, p = .048). Twenty-eight out of 152 participants were hepatitis C (HCV) positive at baseline, and 4 seroconverted within 12 weeks, 2 in each group. HCV status was significantly associated with transaminase abnormalities (p = .009 and p = .006 for ALT an AST, respectively). HCV status had a strong effect on transaminase abnormalities among participants assigned to DETOX, but not among those assigned to BUP. CONCLUSIONS: No evidence was found for hepatotoxicity of buprenorphine in this exploratory analysis. HCV was present in a significant minority of participants and was a significant predictor of transaminase elevation. Results suggest that stabilization on buprenorphine may decrease the frequency of transaminase abnormalities associated with HCV in opioid dependent young people. The high rate of seroconversion underscores the importance of effective treatment and prevention.
Authors: D M Patrick; M W Tyndall; P G Cornelisse; K Li; C H Sherlock; M L Rekart; S A Strathdee; S L Currie; M T Schechter; M V O'Shaughnessy Journal: CMAJ Date: 2001-10-02 Impact factor: 8.262
Authors: T Diaz; D C Des Jarlais; D Vlahov; T E Perlis; V Edwards; S R Friedman; R Rockwell; D Hoover; I T Williams; E R Monterroso Journal: Am J Public Health Date: 2001-01 Impact factor: 9.308
Authors: Christopher S Murrill; Howard Weeks; Brian C Castrucci; Hillard S Weinstock; Beth P Bell; Catherine Spruill; Marta Gwinn Journal: Am J Public Health Date: 2002-03 Impact factor: 9.308
Authors: A Berson; A Gervais; D Cazals; N Boyer; F Durand; J Bernuau; P Marcellin; C Degott; D Valla; D Pessayre Journal: J Hepatol Date: 2001-02 Impact factor: 25.083
Authors: M Zuin; A Giorgini; C Selmi; P M Battezzati; C A Cocchi; A Crosignani; A Benetti; P Invernizzi; M Podda Journal: Dig Liver Dis Date: 2008-02-21 Impact factor: 4.088
Authors: Andrew J Saxon; Walter Ling; Maureen Hillhouse; Christie Thomas; Albert Hasson; Alfonso Ang; Geetha Doraimani; Gudaye Tasissa; Yuliya Lokhnygina; Jeff Leimberger; R Douglas Bruce; John McCarthy; Katharina Wiest; Paul McLaughlin; Richard Bilangi; Allan Cohen; George Woody; Petra Jacobs Journal: Drug Alcohol Depend Date: 2012-08-22 Impact factor: 4.492