Controlled clinical trial to assess the response of recent heroin abusers with chronic hepatitis C virus infection to treatment with interferon alpha-n2b.
BACKGROUND
Chronic infection with hepatitis C virus (HCV) is the most common infectious disease among heroin abusers, but it is recommended that specific treatment with interferon be delayed until at least 6 to 12 months after the end of drug addiction.


OBJECTIVE
We investigated the response of heroin abusers to interferon treatment shortly after the end of detoxification treatment with methadone.


METHODS
We studied 2 homogeneous groups of white Italian patients with chronic HCV infection: former male heroin abusers and males without a history of drug addiction. Tumor necrosis factor, interleukin-1beta, interleukin-2, activated monocytes, anti-HCV antibodies, HCV RNA, and alanine aminotransferase levels were assessed. Standard treatment was initiated with 5 MU interferon alpha-n2b administered subcutaneously once daily for 8 weeks. Patients with negative HCV-RNA findings at the end of 8 weeks received further treatment with 5 MU TIW subcutaneously for an additional 48 weeks.


RESULTS
Thirty of 47 patients in group A (former heroin abusers) and 30 of 30 patients in group B (controls) completed the study. Heroin abusers presented a significantly enhanced response to treatment compared with the controls. After 8 weeks, HCV-RNA test results were negative in 27 of 30 patients in group A (90.0%) and in 25 of 30 in group B (83.3%) (P = NS). Onset of relapse occurred significantly later in heroin abusers (mean [SD], 53 [3] weeks) than in controls (26 [2] weeks) (P < 0.05). Cytokine levels and activated CD11 antigen-expressing monocytes were significantly (P < 0.001) higher in heroin abusers than controls.


CONCLUSIONS
Heroin abusers with chronic HCV infection were successfully treated with interferon alpha-n2b soon after the end of detoxification treatment.
Neri
Sergio
S
Department of Internal Medicine, University of Catania, Saint Martha Hospital, Catania, Italy. sergio.neri4@tin.it
Bruno
Cosimo M
CM
Abate
Giuseppe
G
Ierna
Dario
D
Mauceri
Barbara
B
Cilio
Danila
D
Bordonaro
Fabio
F
Pulvirenti
Davide
D
Italiano
Claudio
C
Caruso
Luciano
L
D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018845:CD11 Antigens / Q000097:blood; D016207:Cytokines / Q000097:blood; D004305:Dose-Response Relationship, Drug; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006556:Heroin Dependence / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D009000:Monocytes / Q000378:metabolism; D011994:Recombinant Proteins
D000998:Antiviral Agents; D018845:CD11 Antigens; D016207:Cytokines; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins