title: Hepatitis C treatment eligibility and comorbid medical illness in methadone maintenance (MMT) and non-MMT patients: a case-control study.
abstract: Comorbid medical illness is common in patients with chronic hepatitis C (HCV) infection and in methadone treatment (MMT) patients, yet little is known about the impact of medical illness on HCV treatment eligibility. Medical illness and HCV treatment eligibility were compared in a case-control study of 80 MMT patients entering an HCV treatment trial and 80 matched non-MMT patients entering HCV treatment in a gastroenterology clinic. 91% of MMT and 85% of non-MMT patients had chronic medical conditions. Despite similar medical severity ratings, a significantly higher proportion (77%) of non-MMT patients were eligible for HCV treatment than were MMT patients (56%) (p<.01). Specific comorbid medical and psychiatric illness led to ineligibility in only 18% of MMT and 16% of non-MMT patients. However, failure to complete the medical evaluation process was significantly (p<.001) more likely to cause ineligibility among MMT patients (19%) than non-MMT patients (0%).
authors.affiliation: San Francisco VA Medical Center, University of California, San Francisco, CA 94121, USA. steven.batki@ucsf.edu
authors.forename: Steven L
authors.initials: SL
authors.lastname: Batki
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Canfield
authors.forename: Emily
authors.initials: E
authors.lastname: Smyth
authors.forename: Robert
authors.initials: R
authors.lastname: Ploutz-Snyder
authors.forename: Robert A
authors.initials: RA
authors.lastname: Levine
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004608:Eligibility Determination; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006305:Health Status Indicators; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D018579:Patient Selection; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000534:rehabilitation*
chemical_list: D009294:Narcotics; D008691:Methadone