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Substitution treatment or active intravenous drug use should not be contraindications for antiviral treatment in drug users with chronic hepatitis C
Author(s) -
Manolakopoulos Spilios,
Deutsch Melanie J.,
Anagnostou Olga,
Karatapanis Stelios,
Tiniakou Elli,
Papatheodoridis George V.,
Georgiou Ekaterini,
Manesis Emmanuel,
Tzourmakliotis Dimitris,
Archimandritis Athanasios J.
Publication year - 2010
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2010.02341.x
Subject(s) - medicine , drug , hepatitis c , antiviral drug , hepatitis b , hepatitis , chronic hepatitis , antiviral therapy , antiviral treatment , pharmacology , immunology , virus
and aims: International guidelines and routine clinical practice express concerns about antiviral treatment in intravenous drug users (IDUs). We analysed the effect of IDU and/or substitution therapy on chronic hepatitis C (CHC) treatment adherence and response. Patients and methods: Intravenous drug users with CHC were divided into three groups: (A) patients on a substitution programme; (B) active users; and (C) past IDUs. Patients were treated according to the standard of care and followed by a specialist team. Results: A total of 175 patients (mean age 39.4±8.8) were included. One hundred and forty‐four (65%) were adherent to therapy (completing treatment and 6 months of follow‐up). Twenty‐two patients (36%) discontinued because of side effects, 28 (46%) discontinued on their own and 11 (18%) completed treatment but did not present at follow‐up. Of 142 patients with available treatment outcome, 99 (69.7%) achieved a sustained virological response (SVR), with no differences among the study groups. Patients with genotypes 2–3 and those who completed the treatment schedule had 2.78‐fold (95% CI: 1.3–5.8) and 6.4‐fold (95% CI: 2.6–15.6) higher probability of achieving SVR. Conclusion: Active use of illicit drugs and/or drug substitution do not affect the treatment outcome in patients with CHC as long as they are closely followed and remain adherent to the treatment.