Injection drug users constitute 60% of the more than 4 million people in the United States with hepatitis C virus (HCV), including many methadone maintenance patients. Few data exist describing clinical outcomes for patients receiving HCV treatment on-site in a methadone maintenance settings. In this retrospective study, we describe clinical outcomes for 73 patients receiving HCV treatment on-site in a methadone maintenance treatment program. Fifty-five percent of patients achieved endof-treatment response, and 45% achieved sustained viral response. These treatment response rates are nearly equivalent to previously published HCV treatment response rates, despite high prevalences of ongoing drug use (49%), psychiatric comorbidity (67%), and HIV coinfection (32%). These data show that on-site HCV treatment with pegylated interferon and ribavirin is effective in methadonemaintained patients, many of whom are active drug users, psychiatrically ill, or HIV coinfected, and that methadone maintenance treatment programs represent an opportunity to safely treat chronic hepatitis C.

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Mycobacterium abscessus is a rapidly growing mycobacterium (RGM) known to be abundant in soil, dust and water. Unlike other non-tuberculous mycobacteria, RGM is typically resistant to first-line anti-tuberculosis drugs. These organisms are known to cause community and hospital-acquired infections; however, central nervous system (CNS) infections caused by these pathogens have not been abundantly reported. As the use of vascular catheters and prosthetic devices is becoming more common, a rise in CNS infections secondary to M. abscessus has been noted. Here, we present such a case where the removal of a ventricular catheter was necessary to guarantee source control and eradication of the infection.

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