Treatment for hepatitis C virus in injection drug users on opioid replacement therapy: a prospective multicentre study

Belfiori, Barbara; Chiodera, Alessandro; Ciliegi, Patrizia; Tosti, Andrea; Baldelli, Franco; Stagni, Giuliano; Francisci, Daniela

doi:10.1097/01.meg.0000280175.79379.04

Cited by 12 publications

(25 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The HCV Ab group also appeared to have more severe medical and employment issues, which was not surprising given that individuals with HCV have been shown to be at higher risk for comorbidities and psychosocial instability, and often have problems adhering to their medication regimen (8–10). …”

Section: Discussionmentioning

confidence: 95%

“…Participants were followed for 28 days post stabilization, regardless of tapering assignment, and were tested for opioid use at the end of each week. Eligible participants were: (1) at least 15 years of age; (2) seeking treatment for opioid dependence at a participating treatment program in one of 10 cities across the US; (3) tested negative for methadone and benzodiazepines; (4) not in poor general health; (5) did not report an allergy to buprenorphine or naloxone; (6) not pregnant or nursing; (7) only dependent on opioids (as opposed to also being dependent on alcohol or other drugs); (8) had not participated in an investigational drug study; (9) had not undergone levo-alpha acetyl methadol (LAAM) or methadone maintenance in the 30 days prior to the trial; (10) did not have legal action pending; (11) able to remain in the area; and (12) did not have any other medical or psychiatric condition that could jeopardize their safety while participating in the trial. With regard to opioid use in the 30 days prior to the trial, participants averaged almost 23 days of heroin use and 6.5 days of opioid analgesic use.…”

Section: Methodsmentioning

confidence: 99%

“…Patients with HCV represent a medical challenge given their relatively high likelihood of comorbidities, psychosocial instability, and non-adherence to treatment regimens (8–10). Non-adherence to HCV treatment is often attributed to a complex treatment regimen and side-effects of the medications, such as depression, anxiety, malaise, fatigue, myalgia and anemia (11).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between hepatitis C virus and opioid use while in buprenorphine treatment: preliminary findings

Murphy

Dweik²,

McPherson

2014

The American Journal of Drug and Alcohol Abuse

View full text Add to dashboard Cite

Background The prevalence of hepatitis-C-virus (HCV) infections is high among opioid-dependent individuals. Prior research on the simultaneous treatment of both conditions has primarily assessed success as it pertains to HCV; although, it has been noted that favorable substance-use-therapy outcomes may improve the likelihood of HCV-treatment initiation and success. Therefore, current guidelines for the treatment of HCV among illicit drug users suggest that treatment for addiction be given the highest priority. Objectives To determine whether opioid-dependent participants in a clinical trial of buprenorphine-treatment tapering regimens, who tested positive for the HCV antibody, experienced significantly different levels of opioid abstinence than those not infected. Methods Data came from the National Drug Abuse Treatment Clinical Trial Network study 0003, in which 516 eligible opioid-dependent participants were randomized to either a 7-day or 28-day buprenorphine tapering schedule following a 4-week buprenorphine stabilization period. Generalized estimating equations were used to test the research question. Results Participants with the HCV antibody were significantly less likely to submit opioid-negative urine analyses during and/or immediately following active treatment [OR = 0.69; CI = 0.51–0.93], which indicates a higher rate of opioid use among this group. Conclusion Individualized opioid-dependence treatment strategies may be required for opioid-dependent individuals who test positive for the HCV antibody in order to ensure resources for both opioid-dependence and HCV therapies are used efficiently.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between hepatitis C virus and opioid use while in buprenorphine treatment: preliminary findings

Murphy

Dweik²,

McPherson

2014

The American Journal of Drug and Alcohol Abuse

View full text Add to dashboard Cite

show abstract

“…We found 11 papers containing data on antiviral therapy for HCV infection in methadone maintenance patients [6][7][8][9][10][11][12][13][14][15][16]. We excluded one study in which some methadone maintenance patients were included in a larger group of injection drug users without delineation of specific results in methadone maintenance patients [8], two papers which were retrospective [11,12] and one [16] which did not have as a stated aim [17] the study of methadone maintenance patients.…”

Section: Methodsmentioning

confidence: 99%

Critical issues in the treatment of hepatitis C virus infection in methadone maintenance patients

Novick

Kreek

2008

Addiction

View full text Add to dashboard Cite

show abstract

“…Current European guidelines, with the exception of France, contain restrictive recommendations for therapy in patients actively injecting drugs (10) . Furthermore, these patients are usually excluded from clinical studies as they are believed to manifest high-risk behavior (2,4,9) . Thus, the therapeutic algorithm of CHC still remains controversial in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

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

Papadopoulos

Gogou

Mylopoulou

et al. 2010

Arq. Gastroenterol.

View full text Add to dashboard Cite

-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.

show abstract

Treatment for hepatitis C virus in injection drug users on opioid replacement therapy: a prospective multicentre study

Cited by 12 publications

References 5 publications

Association between hepatitis C virus and opioid use while in buprenorphine treatment: preliminary findings

Association between hepatitis C virus and opioid use while in buprenorphine treatment: preliminary findings

Critical issues in the treatment of hepatitis C virus infection in methadone maintenance patients

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

Contact Info

Product

Resources

About