Hepatitis C treatment of opioid dependants receiving maintenance treatment: results of a Norwegian pilot study.
BACKGROUND
Many physicians are still skeptic to treat opioid dependants, with or without maintenance treatment, for hepatitis C (HCV) because of concerns about psychiatric comorbidity, stability and adherence. In Norway, there are about 3,500 patients participating in the restrictive medication-assisted rehabilitation (LAR) programs in which all patients are given methadone or buprenorphine maintenance therapy. This study was undertaken to determine whether HCV combination therapy with pegylated interferon alpha-2a plus ribavirin is feasible, efficient and safe in this patient group.


METHODS
Seventeen patients with HCV genotype 3a were treated for 24 weeks. To optimize compliance, the treatment was given from a department of infectious diseases in cooperation with an LAR center. All injections were given in the LAR center and the patients were given psychosocial support.


RESULTS
The compliance was 100%. All responded to the therapy and 16 (94%) were sustained responders.


CONCLUSIONS
This study indicates that compliance and treatment outcome of opioid dependants on methadone or buprenorphine maintenance after 24 weeks of HCV treatment corresponds to that for non-dependants if extra support is given. The treatment should be undertaken in collaboration with specialists in addiction medicine, hepatology and infectious diseases.
Krook
Aud L
AL
Unit for Addiction Medicine, Institute of Psychiatry, University of Oslo, and Clinic of Abuse and Dependence, Aker University Hospital HF, Oslo, Norway. aud.krook@gmail.com
Stokka
Dorthe
D
Heger
Bernt
B
Nygaard
Egil
E
D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects; D009664:Norway; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010865:Pilot Projects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000534:rehabilitation*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009294:Narcotics; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D002047:Buprenorphine; D012254:Ribavirin; C100416:peginterferon alfa-2a; D008691:Methadone