Hepatitis C virus eradication in intravenous drug users maintained with subcutaneous naltrexone implants
- 1 January 2006
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Hepatology
- Vol. 45 (1), 111-117
- https://doi.org/10.1002/hep.21470
Abstract
The effectiveness of HCV antiviral therapy in patients who have undergone recent drug dependency treatment and continue to inject drugs sporadically is presently not clear. Patients attending a community‐based drug rehabilitation and naltrexone implant clinic from October 2002 until March 2005 were screened for HCV infection and if positive offered further assessment and treatment with interferon and ribavirin therapy. The first 50 patients to commence HCV therapy and complete at least 6 months follow‐up were prospectively studied. ETR response (HCV PCR negative) was 34/50 (68%) and SVR 6 months post‐treatment was 31/50 (62%). Viral eradication was maintained in those 22 patients that have had 12 months or more post‐treatment follow‐up. Eleven (22%) patients stopped therapy early due to side effects or poor compliance. Only two patients with an ETR likely reinfected due to unsafe injection practices. One was re‐treated and achieved an SVR. Of the patients achieving a 6‐month SVR, 17 of 31 patients reported no further IDU and 13 of 31 patients occasional IDU during treatment and this was maintained after HCV treatment cessation. 46% of patients received antidepressant and/or antipsychotic medication during treatment. Conclusion: This study of HCV treatment in a community‐based subcutaneous naltrexone implant clinic found antiviral therapy resulted in a 62% SVR. This result is comparable to that reported in hospital‐based clinics in non‐IDU patients. The side effect profile and compliance was also similar. HCV antiviral therapy should be offered to this large and currently under treated group. (HEPATOLOGY 2007;45:111–117.)Keywords
This publication has 30 references indexed in Scilit:
- Peginterferon Alfa-2b Therapy in Acute Hepatitis C: Impact of Onset of Therapy on Sustained Virologic ResponseGastroenterology, 2006
- The impact of past alcohol use on treatment response rates in patients with chronic hepatitis CAlimentary Pharmacology & Therapeutics, 2005
- Estimating the impact of hepatitis C virus therapy on future liver-related morbidity, mortality and costs related to chronic hepatitis CJournal of Hepatology, 2005
- Opioid Therapy and ImmunosuppressionClinical Journal of Sport Medicine, 2004
- Diagnosis, management, and treatment of hepatitis CHepatology, 2004
- Blood naltrexone and 6‐ß‐naltrexol levels following naltrexone implant: comparing two naltrexone implantsAddiction Biology, 2004
- Liver transplantation for HCV-associated liver cirrhosis: Predictors of outcomes in a population with significant genotype 3 and 4 distributionLiver Transplantation, 2003
- Role of maintenance treatment in opioid dependenceThe Lancet, 1999
- Injecting nation: achieving control of hepatitis C in AustraliaDrug and Alcohol Review, 1997
- Methadone Maintenance and the Likelihood of Risky Needle-SharingInternational Journal of the Addictions, 1995