Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes.
OBJECTIVE
To evaluate the effect of a multi-disciplinary standardized management model on the efficacy of pegylated (Peg)-interferon alpha-2b plus ribavirin treatment of chronic hepatitis C in drug addicts undergoing substitutive or antagonist therapy.


METHODS
Observational prospective multi-centre study.


METHODS
Six clinical infectious disease centres in collaboration with 11 drug dependency units (DDU) in five Italian regions.


METHODS
Intravenous drug users affected by chronic hepatitis C engaged in detoxification programmes.


METHODS
Application of a multi-disciplinary standardized management model for HCV treatment involving DDU operators, psychologists or psychiatrists and infectious disease specialists.


METHODS
Very early, early, end-of-treatment and sustained virological response to Peg-interferon alpha-2b plus ribavirin.


RESULTS
Fifty-three subjects were studied [43.4% with hepatitis C virus (HCV) genotypes 1 or 4]. Intent-to-treat analysis showed an end-of-treatment virological response in 58.5% of patients (39.1% genotypes 1 or 4; 73.4% genotype 3) and a sustained virological response in 54.7% (34.8% genotypes 1 or 4; 70.0% genotype 3). There were 19 (35.8%) dropouts and three (5.7%) non-responders: one genotype 1 and two genotype 4. Two (3.8%) patients relapsed: genotypes 1 and 3. On-treatment analysis showed negative HCV-RNA in 40 (93.1%) of 43 subjects who completed the first 12 treatment weeks and in 35 who completed the first 24 treatment weeks. All subjects with an end-of-treatment response, except one with genotype 3 infection, had a sustained response.


CONCLUSIONS
Our data show that antiviral treatment in the context of a multi-disciplinary standardized management model helps many HCV-positive drug addicts achieve a good virological response.
Guadagnino
Vincenzo
V
Chair of Infectious Diseases, Postgraduate School of Infectious Diseases, University Magna Graecia of Catanzaro, Italy. vguadagnino@unicz.it
Trotta
Maria Paola
MP
Montesano
Franco
F
Babudieri
Sergio
S
Caroleo
Benedetto
B
Armignacco
Orlando
O
Carioti
Jessica
J
Maio
Giuseppe
G
Monarca
Roberto
R
Antinori
Andrea
A
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D015819:Substance Abuse, Intravenous / Q000628:therapy*; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b