title: Clinical experience with the treatment of hepatitis C infection in patients on opioid pharmacotherapy.
abstract: OBJECTIVE
  To evaluate the efficacy, safety and adherence to hepatitis C (HCV) therapy in patients attending tertiary hepatitis clinics who are receiving opioid replacement therapy.
  
  
  METHODS
  A non-randomized, open-label study. Participants were treated with pegylated interferon alpha-2a and weight-based ribavirin for 24 weeks (genotype non-1, n = 31) or 48 weeks (genotype 1, n = 22).
  
  
  METHODS
  Four tertiary hospital hepatitis clinics in Australia.
  
  
  METHODS
  Fifty-three patients with chronic HCV who were receiving opioid replacement therapy.
  
  
  METHODS
  Patients were monitored for virological response, adverse events and adherence. They were also screened for psychiatric illness prior to and throughout the study utilizing two validated instruments: the Mini International Neuropsychiatric Interview (MINI) and Beck Depression Interview (BDI)-II.
  
  
  RESULTS
  The overall sustained virological response (SVR) rate was 57% (71% genotype non-1 versus 36% genotype 1), and was similar in active injectors (63%) and non-injectors (53%). The psychological profile of patients based on validated instruments did not change on therapy. The pattern and frequency of adverse effects were comparable to non-opioid replacement patients. Eighty-five per cent of patients were adherent to therapy by 80/80/80 criteria and only two patients who had an end-of-treatment response relapsed, one of whom was not an active injector.
  
  
  CONCLUSIONS
  Patients on opioid replacement therapy, even if they continue to inject actively, can achieve comparable sustained virological response rates to other populations with pegylated interferon alpha-2a and ribavirin therapy, suffer no excess rates of adverse effects or psychological complications and have good adherence to therapy.
authors.affiliation: Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, VIC, Australia. j.sasadeusz@mh.org.au
authors.forename: Joseph John
authors.initials: JJ
authors.lastname: Sasadeusz
authors.forename: Gregory
authors.initials: G
authors.lastname: Dore
authors.forename: Ian
authors.initials: I
authors.lastname: Kronborg
authors.forename: David
authors.initials: D
authors.lastname: Barton
authors.forename: Motoko
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Martin
authors.initials: M
authors.lastname: Weltman
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia; D003865:Major Depressive Disorder / Q000453:epidemiology; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D058850:Opiate Substitution Treatment; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a