title: Successful treatment of chronic hepatitis C with pegylated interferon in combination with ribavirin in a methadone maintenance treatment program.
abstract: Injection drug users constitute 60% of the more than 4 million people in the United States with hepatitis C virus (HCV), including many methadone maintenance patients. Few data exist describing clinical outcomes for patients receiving HCV treatment on-site in methadone maintenance settings. In this retrospective study, we describe clinical outcomes for 73 patients receiving HCV treatment on-site in a methadone maintenance treatment program. Fifty-five percent of patients achieved end-of-treatment response, and 45% achieved sustained viral response. These treatment response rates are nearly equivalent to previously published HCV treatment response rates, despite high prevalences of ongoing drug use (49%), psychiatric comorbidity (67%), and HIV coinfection (32%). These data show that on-site HCV treatment with pegylated interferon and ribavirin is effective in methadone-maintained patients, many of whom are active drug users, psychiatrically ill, or HIV coinfected, and that methadone maintenance treatment programs represent an opportunity to safely treat chronic hepatitis C.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA. alitwin@montefiore.org
authors.forename: Alain H
authors.initials: AH
authors.lastname: Litwin
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Harris
authors.forename: Shadi
authors.initials: S
authors.lastname: Nahvi
authors.forename: Philippe J
authors.initials: PJ
authors.lastname: Zamor
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Soloway
authors.forename: Peter L
authors.initials: PL
authors.lastname: Tenore
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaswan
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D017831:Diagnosis, Dual (Psychiatry); D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications / Q000534:rehabilitation; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000534:rehabilitation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a; D008691:Methadone