Treatment of Intravenous Drug Users (Idus) with Chronic Hepatitis C, Receiving Opioid Replacement with Buprenorphine in Central Greece. Effectiveness, Tolerability and Compliance

Author: IOANNIS XYNOTROULAS, Delistathi Aikaterini, Frongou Dimitra, Founta Alexandra, Lytotseta Eleni, Kostaki Eugenia, Antoniadou Pagona, Tsiaka Georgia

Theme: Clinical Research Year: 2015

BACKGROUND:Hepatitis C virus(HCV)infection is a global health problem.In Western countries,intravenous drug users(IDUs)constitute the largest proportion of HCV patients.In Clinical Research practice,few IDUs have access to HCV treatment,likely because many physicians believe these patients will have poor adherence to treatment.AIMS:The aim of this study was to assess effectiveness,tolerability and compliance of combination treatment in IDUs,receiving opioid replacement with Buprenorphine in Central Greece. The results will be compare to results from study of CHC treatment in the general population.METHODS:We retrospectively evaluated safety,compliance and efficacy of treatment in 41 IDUs with CHC,who were in Buprenorphine substitution and were attending our clinics the period between 2005 and December 2014 and in 29 patients with CHC from the general population.Treatment consisted of pegylated IFN-a and Ribavirin:24 weeks for genotype 2,3and 48 weeks for genotype 1,4.Patients(IDUs) were treated according to the standard of care and followed by a specialist team.CHARACTERISTICS:Table1. RESULTS:1:Of 41 IDUs patients,37 completed therapy(90.24%)and all of 29 patients.2:The rate of psychiatric severe adverse events(such as depression,anguish and irritability)that led to treatment discontinuation was 4.87%(2/41).3:4.87%(2/41)of IDUs discontinued treatment because of personal reasons.4:Sustained Virogical Response(SVR)was achieved in 30 of 41 IDUs patients(73.17%) and in 22 of 29 patients(75.86%).5:Only one patient(IDUs)seemed reinfection 5 years after successful therapy.CONCLUSION:Treatment for CHC seems reasonably safe and sufficiently effective in IDUs with Buprenorphine substitution.Close monitoring and psychological support can augment adherence to therapy and improve response rates in this difficult to treat patient population.This study shows that findings on effectiveness, tolerability and compliance are comparable to those in the general population.

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