title: Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes.
abstract: 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.
authors.affiliation: Chair of Infectious Diseases, Postgraduate School of Infectious Diseases, University Magna Graecia of Catanzaro, Italy. vguadagnino@unicz.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Guadagnino
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Trotta
authors.forename: Franco
authors.initials: F
authors.lastname: Montesano
authors.forename: Sergio
authors.initials: S
authors.lastname: Babudieri
authors.forename: Benedetto
authors.initials: B
authors.lastname: Caroleo
authors.forename: Orlando
authors.initials: O
authors.lastname: Armignacco
authors.forename: Jessica
authors.initials: J
authors.lastname: Carioti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maio
authors.forename: Roberto
authors.initials: R
authors.lastname: Monarca
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b