Peginterferon/ribavirin treatment achieves a higher  compliance rate than interferon/ribavirin combination  in patients chronically infected with HCV on methadone  maintenance.
BACKGROUND
Chronic hepatitis C virus infection (HCV) is the most common infectious disease among intravenous drug users.


OBJECTIVE
To determine and compare compliance rates between two groups of chronic HCV patients from the methadone substitution program of the National Greek Organization Against Drugs treated with either pegylated interferon alpha-2b/ribavirin or with interferon alpha-2b/ribavirin during 48 weeks of therapy and 24 weeks of follow-up. Furthermore, to evaluate the efficacy of each treatment modality.


METHODS
Forty-five consecutive methadone maintenance (MM) patients (group A, 36 males, nine females) were treated with pegylated interferon alpha-2b (weight-based dosing 1.5 microg/kg/week) and ribavirin 1000-1200 mg/day orally. Sixty-five consecutive MM patients (group B, 52 males, 13 females) were treated with interferon alpha-2b (6 MIU, three times/week) and ribavirin with the doses reported above. During the study, all patients were followed up periodically by hepatologists, internists, and psychiatrists.


RESULTS
Baseline characteristics were similar between the two groups. Thirty-four out of 45 patients (75.6%) from group A and 31 of 65 patients (47.7%) from group B completed therapy (P =0.006). Thirty-two (71.1%) patients from group A and 27 patients (41.5%) from group B were followed-up until the end of week 72 (P = 0.004). At the end of the follow-up, sustained virologic response was achieved in 23 of 45 (51.1%) patients from group A and 21 of 65 patients (32.3%) from group B (P =0.075).


CONCLUSIONS
Pegylated interferon alpha-2b/ribavirin treatment achieved a significantly higher compliance rate than interferon alpha-2b/ribavirin in MM patients with chronic HCV infection. After 24 weeks of follow-up, response rates were similar for patients who were compliant to treatment for both groups.
Dimitroulopoulos
Dimitrios
D
Department of Gastroenterology, Agios Savvas Hospital, Athens, Greece. dimdim@otenet.gr
Petroulaki
Elefteria
E
Manolakopoulos
Spilios
S
Anagnostou
Olga
O
Tsaklakidou
Domna
D
Xinopoulos
Dimitrios
D
Tsamakidis
Klisthenis
K
Tzourmakliotis
Dimitrios
D
Paraskevas
Emmanouel
E
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008691:Methadone; D058850:Opiate Substitution Treatment; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000534:rehabilitation; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; D008691:Methadone