Peginterferon plus Ribavirin for chronic hepatitis C in opiate addicts on methadone/buprenorphine maintenance therapy

Belfiori, Barbara; Ciliegi, Patrizia; Chiodera, Alessandro; Bacosi, D.; Tosti, Andrea; Baldelli, Franco; Francisci, Daniela

doi:10.1016/j.dld.2008.08.009

Cited by 34 publications

(23 citation statements)

References 20 publications

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“…A number of factors have been shown to negatively influence adherence including shorter periods of abstinence prior to initiating HCV treatment, relapse to regular drug use, and lack of psychosocial support (Krook et al, 2007;Sylvestre, & Clements, 2007). Given this, it is not surprising that a wide variation in SVR has been reported in IDUs ranging between 20% and 70% (Anagnostou et al, 2008;Belfiori et al, 2009;Ciaccio et al, 2007;Mauss et a., 2004;Robaeys et al, 2006;van Thiel et al, 2003). However, an increasing number of studies have shown that both active IDUs and those participating in substitution therapy can show similar rates of adherence and SVR to non-IDUs, although in general, active users are more likely to refuse treatment, drop out from therapy, or be lost to follow-up (Anagnostou et al, 2008;Pellicelli et al, 2008;Robaeys et al, 2006).…”

Section: Discussionmentioning

confidence: 93%

High rates of sustained virological response in hepatitis C virus-infected injection drug users receiving directly observed therapy with peginterferon alpha-2a (40KD) (PEGASYS) and once-daily ribavirin

Waizmann¹,

Ackermann²

2010

Journal of Substance Abuse Treatment

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Section: Discussionmentioning

confidence: 93%

High rates of sustained virological response in hepatitis C virus-infected injection drug users receiving directly observed therapy with peginterferon alpha-2a (40KD) (PEGASYS) and once-daily ribavirin

Waizmann¹,

Ackermann²

2010

Journal of Substance Abuse Treatment

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“…• A multidisciplinary approach through the collaboration of addiction specialists, hepatologists, infectious disease experts, clinical psychologists, nurses and prison physicians should be adopted [72]. …”

Section: General Recommendationsmentioning

confidence: 99%

Hepatitis C in European prisons: a call for an evidence-informed response

2014

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Globally, over 10 million people are held in prisons and other places of detention at any given time. People who inject drugs (PWID) comprise 10-48% of male and 30-60% of female prisoners. The spread of hepatitis C in prisons is clearly driven by injection drug use, with many infected prisoners unaware of their infection status. Risk behaviour for acquisition of hepatitis C via common use of injecting equipment is widespread in many prison settings.In custodial settings, effective and efficient prevention models applied in the community are very rarely implemented. Only approximately 60 out of more than 10,000 prisons worldwide provide needle exchange. Thus, HCV prevention is almost exclusively limited to verbal advice, leaflets and other measures directed to cognitive behavioural change. Although the outcome of HCV antiviral treatment is comparable to non-substance users and substance users out of prison, the uptake for antiviral treatment is extremely low.Based on a literature review to assess the spread of hepatitis C among prisoners and to learn more about the impact for the prison system, recommendations regarding hepatitis C prevention, screening and treatment in prisons have been formulated in this article.

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“…Thus, there is much urge to identify and treat drug addicts with chronic hepatitis C (CHC). However, in this group of patients, coinfection with hepatitis B virus (HBV), hepatitis D virus (HDV), and human immunodeficiency virus (HIV), along with alcohol abuse, and psychiatric illnesses (sometimes aggravated by interferon), may impact negatively on the evolution of HCV infection, and the complience to therapy, necessitating a rather multidisciplinary setting (3,5,8,12,13) As indicated in recent studies, the treatment of CHC with peginterferon plus ribavirin in opiate addicts under methadone and/or buprenorphine maintenance therapy is well tolerated and offers a fairly good success rate, provided that close cooperation with specialists in drug addiction and psychiatrists is provided (3,7) . Despite the above mentioned results, among patients with CHC eligible for treatment, active injecting drug users, not receiving substitution therapy, still constitute a distinct group.…”

Section: Introductionmentioning

confidence: 99%

Should active injecting drug users receive treatment for chronic hepatitis C?

Papadopoulos

Gogou

Mylopoulou

et al. 2010

Arq. Gastroenterol.

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-Context -Accumulating data propose that active injecting drug users might not differ from the general population in terms of sustained virological response when adherent to therapy for chronic hepatitis C. However, current guidelines contain restrictive recommendations for therapy in this group of patients. Objective -Therefore, we evaluated a cohort of chronic hepatitis C patients regarding the potent influence of active drug using on initial informed consent, compliance and sustained virological response to treatment. Method -For that purpose, 162 consecutive patients (of which 62 active injecting drug users), who had been evaluated during the last 6 years in our center for chronic hepatitis C and proposed to receive treatment with pegylated interferon alpha and ribavirin, were enrolled. Initial informed consent, compliance, and sustained virological response as well as data regarding age, gender, body mass index, genotype, viral load, coinfection with HBV/HDV/HIV, administered interferon alpha (2a or 2b), liver function tests, liver histology, urban residence, ethnicity, and concomitant use of alcohol were collected and analyzed in respect with injecting drug using. Results -Injecting drug using was positively correlated with male gender (P<0.001), young age (P<0.001), native origin (P = 0.043), and concomitant use of alcohol (P<0.001). Comparable initial informed consent (P = 0.836), compliance (P = 0.879), and sustained virological response (P = 0.132) were observed between injecting drug users and non-injecting drug users. The results were confirmed using a multiple regression model. Conclusion -Our data further support that active injecting drug users do not constitute a distinct chronic hepatitis C patient group in terms of initial informed consent, compliance, or sustained virological response. Therefore, injecting drug using should not be a major determinant influencing the decision for treatment of chronic hepatitis C in eligible patients.

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Peginterferon plus Ribavirin for chronic hepatitis C in opiate addicts on methadone/buprenorphine maintenance therapy

Cited by 34 publications

References 20 publications

High rates of sustained virological response in hepatitis C virus-infected injection drug users receiving directly observed therapy with peginterferon alpha-2a (40KD) (PEGASYS) and once-daily ribavirin

High rates of sustained virological response in hepatitis C virus-infected injection drug users receiving directly observed therapy with peginterferon alpha-2a (40KD) (PEGASYS) and once-daily ribavirin

Hepatitis C in European prisons: a call for an evidence-informed response

Should active injecting drug users receive treatment for chronic hepatitis C?

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