title: Immune response in addicts with chronic hepatitis C treated with interferon and ribavirin.
abstract: BACKGROUND
  The role played by the immune system in the progression of chronic hepatitis C (CHC) is not completely clear. Opioids may facilitate the outbreak of infections through marked immunomodulating effects on the immune response against a virus. To asses if addicts can be treated successfully with interferon (IFN) during detoxification treatment, we evaluated some immune response mediators in addicts affected by CHC.
  
  
  METHODS
  A cohort of heroin users with CHC were enrolled during the detoxification period, divided into two groups and treated with IFN pegilate plus ribavirin (group A treated during methadone administration and group B treated at week 8 after methadone treatment completed). A group of patients with CHC and no history of drug addiction were enrolled as controls. Leukocyte subpopulation NK, CD4+, CD8+ and some cytokines Th1 (IFNgamma, interleukin [IL]2) and Th2 (IL-6, IL-10) were evaluated prior to, during and after methadone treatment. Sustained virological response was evaluated 24 weeks after antiviral treatment was completed.
  
  
  RESULTS
  During methadone treatment, significantly (P < 0.05) higher cytokine Th1 and NK and lower cytokine Th2 levels were observed in groups A and B compared with levels obtained before treatment in the same groups. Relapse occurred at 56 +/- 8 weeks in 34/55 group A patients, at 24 +/- 8 weeks in 33/52 group B patients and at 24 +/- 4 weeks in group C, there being a significant difference (P < 0.05) between group A and B and between group A and C. No significant differences between all groups were detected in CD4+ and CD8+ cell counts.
  
  
  CONCLUSIONS
  Our results revealed that drug addicts with CHC can be treated successfully with IFN pegilate and ribavirin. This therapy can be recommended during the early phase of detoxification treatment to achieve a sustained response.
authors.affiliation: Department of Internal Medicine and Systemic Diseases, University of Catania, Cantania, Italy. sergio.nei4@tin.it
authors.forename: Neri
authors.initials: N
authors.lastname: Sergio
authors.forename: Travali
authors.initials: T
authors.lastname: Salvatore
authors.forename: Bertino
authors.initials: B
authors.lastname: Gaetano
authors.forename: Pulvirenti
authors.initials: P
authors.lastname: Davide
authors.forename: Italiano
authors.initials: I
authors.lastname: Claudio
authors.forename: Libbra
authors.initials: L
authors.lastname: Massimo
authors.forename: Mauceri
authors.initials: M
authors.lastname: Barbara
authors.forename: Abate
authors.initials: A
authors.lastname: Giuseppe
authors.forename: Calvagno
authors.initials: C
authors.lastname: Stefano
authors.forename: Cilio
authors.initials: C
authors.lastname: Danila
authors.forename: Tsami
authors.initials: T
authors.lastname: Aikaterini
authors.forename: Ignaccolo
authors.initials: I
authors.lastname: Luca
authors.forename: Callari
authors.initials: C
authors.lastname: Daniela
authors.forename: Caruso
authors.initials: C
authors.lastname: Luciano
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000276:immunology* / Q000534:rehabilitation; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin; D008691:Methadone