Successful treatment of chronic hepatitis C with pegylated interferon in combination with ribavirin in a methadone maintenance treatment program.
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.
Litwin
Alain H
AH
Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA. alitwin@montefiore.org
Harris
Kenneth A
KA
Nahvi
Shadi
S
Zamor
Philippe J
PJ
Soloway
Irene J
IJ
Tenore
Peter L
PL
Kaswan
Daniel
D
Gourevitch
Marc N
MN
Arnsten
Julia H
JH
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
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