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| |  IV Drugs Users on Opioid Substitution Respond to Antiviral Treatment for HCV: Presented at DDW By Charlene Laino NEW ORLEANS -- May 11, 2010 -- Intravenous (IV) drug users who are on opioid substitution and infected with hepatitis C virus (HCV) can be successfully treated with antiviral therapy, researchers reported here at Digestive Disease Week (DDW) 2010. Olga Anagnostou, MD, Greek Organization Against Drugs (OKANA), Athens, Greece, presented the findings here on May 3. Intravenous drug use is a main cause of HCV transmission in Western countries, but such patients are sometimes excluded from antiviral treatment because of concerns regarding low adherence and response rates in treatment, she said. Dr. Anagnostou and colleagues evaluate HCV treatment outcomes among IV drug users receiving opioid substitution treatment with methadone or buprenorphine at 4 government-funded clinics between 2002 and 2008. The analysis involved 93 IV drug users with HCV infection who started combination treatment with pegylated interferon alfa-2a or -2b and ribavirin while on methadone or buprenorphine. Forty-six (48.4%) patients were on methadone, and 49 (51.6%) were on buprenorphine. Of the total, 77 (82.8%) patients completed their antiviral treatment schedule, 7 (7.5%) discontinued treatment due to side effects, and 9 (9.7%) dropped out due to their own reasons. At 6 months, 66.7% of patients had sustained virologic responses. Substitution treatment with buprenorphine was associated with both higher adherence rates (27.3% vs 8.1%, P = .04) and higher sustained viral response rates (83.3% vs 48.9%, P = .002), compared with methadone use. In multivariate analyses, adherence to treatment (P < .0001) and buprenorphine use (P = .007) were independently associated with a greater chance of sustained virologic response. Buprenorphine may be a more effective treatment for opioid withdrawal, Dr. Anagnostou said during a press briefing. The bottom line, she said, is that intravenous drug users should not be excluded from antiviral treatment. "They can get treated as long as they adhere, and they do adhere when they are treated in a setting such as this one," she said. Digestive Disease Week 2010 is cosponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT). [Presentation title: The Significance of Buprenorfine Use and Adherence in AntiHCV Treatment Outcome in Drug Users. Abstract M1883]
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