Marcia Russell1, Mary Patricia Pauly2, Charles Denton Moore3, Constance Chia3, Jennifer Mary Dorrell3, Renee Junko Cunanan2, Gayle Witt2. 1. Prevention Research Center, 1995 University Avenue, Suite 450, Berkeley, CA 94704, United States. Electronic address: russell@prev.org. 2. Department of Gastroenterology and Hepatology, Kaiser Permanente North Valley Medical Center, 2025 Morse Avenue, Sacramento, CA 95825, United States. 3. Kaiser Permanente Health Plan, Chemical Dependency Recovery Program, 2829 Watt Avenue, Suite 150, Sacramento, CA 95821, United States.
Abstract
BACKGROUND: The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. METHODS: Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). RESULTS: The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p=0.045), but lower SVR rates (40.9% compared with 62.5%, p=0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p=0.053). CONCLUSION: A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged.
BACKGROUND: The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. METHODS: Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). RESULTS: The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p=0.045), but lower SVR rates (40.9% compared with 62.5%, p=0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p=0.053). CONCLUSION: A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged.
Authors: M Russell; J R Marshall; M Trevisan; J L Freudenheim; A W Chan; N Markovic; J E Vána; R L Priore Journal: Am J Epidemiol Date: 1997-12-01 Impact factor: 4.897
Authors: Brennan M R Spiegel; Zobair M Younossi; Ron D Hays; Dennis Revicki; Sean Robbins; Fasiha Kanwal Journal: Hepatology Date: 2005-04 Impact factor: 17.425