Successful treatment of chronic hepatitis C with pegylated interferon in combination with ribavirin in a methadone maintenance treatment program

Abstract 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 methadone maintenance settings....

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Bibliographic Details
Published in:Journal of substance abuse treatment 2009-07, Vol.37 (1), p.32-40
Main Authors: Litwin, Alain H., M.D., M.P.H., M.S, Harris, Kenneth A., M.D., Ph.D, Nahvi, Shadi, M.D, Zamor, Philippe J., M.D, Soloway, Irene J., R.P.A, Tenore, Peter L., M.D, Kaswan, Daniel, M.D, Gourevitch, Marc. N., M.D., M.P.H, Arnsten, Julia H., M.D., M.P.H
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - therapeutic use
Antiviral Agents - therapeutic use
Biological and medical sciences
Chronic hepatitis C
Clinical outcomes
Desintoxication. Drug withdrawal
Diagnosis, Dual (Psychiatry)
Digestive system
Drug Therapy, Combination
Drug use
Female
HCV
Hepatitis
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
HIV Infections - complications
Human immunodeficiency virus
Humans
Interferon
Interferon-alpha - therapeutic use
Male
Medical sciences
Methadone
Methadone - therapeutic use
Methadone maintenance
Miscellaneous
Opiate agonist treatment
Opioid-Related Disorders - complications
Opioid-Related Disorders - rehabilitation
Pharmacology. Drug treatments
Polyethylene Glycols - therapeutic use
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Public health. Hygiene
Public health. Hygiene-occupational medicine
Recombinant Proteins
Retrospective Studies
Ribavirin - therapeutic use
Studies
Substance abuse treatment
Substance Abuse, Intravenous - complications
Substance Abuse, Intravenous - rehabilitation
Treatment Outcome
Treatments
United States - epidemiology
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Summary:Abstract 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 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 end-of-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 methadone-maintained 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.
ISSN:0740-5472
1873-6483
DOI:10.1016/j.jsat.2008.09.009