[Short-term treatment of Hepatitis C in heroin-dependent patients].
BACKGROUND
Standardized treatment (24-week) with pegylated interferon and ribavirin induces sustained virological response in 80 % of patients with Hepatitis C (HCV) genotype 2 or 3. Most patients who are dependent on heroin and receiving methadone maintenance therapy (MMT) have been excluded from this treatment due to concerns about compliance. Short-term therapy (14 weeks) of other patient groups have shown promising results. The purpose of this study was to investigate the feasibility, efficacy and adverse effects of short-term treatment in a group of MMT patients with chronic hepatitis C infection genotype 3.


METHODS
Eight such patients were treated with weekly pegylated interferon injections (180 microg) and daily ribavirin tablets (800 mg) for 14 weeks. A nurse gave the injections and the patients were followed-up closely with weekly meetings, telephone and SMS.


RESULTS
Virus was eradicated in all patients after four weeks (RVR = 100 %). Seven patients completed treatment and all had undetectable virus at 14 weeks (88 %). At follow-up six months post treatment, six patients had sustained virus response (SVR = 75 %), the last patient refused to be tested. The adverse effects were of moderate intensity and could be treated with dose adjustments and supportive therapy, without additional medication. Drug abuse was a minor problem during treatment and no one relapsed to drug injections.


CONCLUSIONS
Short-term (14 weeks) therapy with pegylated interferon and ribavirin can then be feasible, efficient and safe for Hepatitis C genotype 3. We stress the importance of close monitoring and support from a multidisciplinary team. MMT is a good opportunity to introduce HCV treatment.
Kristensen
Øistein
Ø
Avdeling for rus- og avhengighetsbehandling, Sørlandet sykehus, 4604 Kristiansand, Norway. oistein.kristensen@sshf.no
Sundøy
Anders
A
Skeie
Karin
K
Vederhus
John-Kåre
JK
Øye
Ingebjørg
I
Opsal
Anne
A
Rysstad
Ole
O
Gallefoss
Frode
F
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006556:Heroin Dependence / Q000150:complications / Q000534:rehabilitation / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010348:Patient Care Team; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000821:virology*; D013997:Time Factors; 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