Efficacy of chronic hepatitis C therapy with pegylated interferon and ribavirin in patients on methadone maintenance treatment

• Published in: European journal of clinical microbiology & infectious diseases Vol. 31; no. 6; pp. 1225 - 1232
• Main Authors: Neukam, K., Mira, J. A., Gilabert, I., Claro, E., Vázquez, M. J., Cifuentes, C., García-Rey, S., Merchante, N., Almeida, C., Macías, J., Pineda, J. A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-06-2012; Springer; Springer Nature B.V
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - administration & dosage; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Clinical medicine; Cohort analysis; Cohort Studies; Drug dosages; Female; Genotypes; Hepacivirus - isolation & purification; Hepatitis; Hepatitis C; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; HIV; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Interferon; Interferons - administration & dosage; Internal Medicine; Male; Medical Microbiology; Medical sciences; Methadone; Methadone - administration & dosage; Middle Aged; MMT; Opiate Substitution Treatment - methods; Opioid-Related Disorders - complications; Opioid-Related Disorders - drug therapy; Pharmacology. Drug treatments; Plasma; Prospective Studies; Ribavirin; Ribavirin - administration & dosage; Treatment Outcome; Viral diseases; Viral hepatitis; Viral Load; Spain; Methadone Maintenance Treatment; High Sustained Virologic Response Rate; Sustained Virologic Response; Sustained Virologic Response Rate; Direct Observe Therapy; Human; Microbiology; Cytokine; Opiates; Hepatic disease; Methadone; Narcotic analgesic; Ribavirin; Infection; Viral disease; Maintenance treatment; Nucleoside analog; Digestive diseases; Antiviral; Interferon; Pegylated form; Viral hepatitis C
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-011-1433-5

A considerable number of patients undergoing methadone maintenance treatment (MMT) are not considered for treatment against hepatitis C virus (HCV) infection due to a possible lower adherence and efficacy in this population. We aimed to compare the response rates to HCV treatment in patients with or without MMT. HCV-infected patients who initiated pegylated interferon plus ribavirin were included in this prospective cohort study. The relation between sustained virologic response (SVR) and MMT was analyzed. A total of 214 patients were included in the study [81 (37.9%) with and 133 (62.1%) without MMT]. No differences in HCV and interleukin 28B (rs12979860) genotype distribution were observed between the two groups. Of these patients, 103 (48.1%) achieved SVR. Among the patients who received MMT, 39 (48.1%) reached SVR compared to 64 (48.1%) subjects without MMT (
p
 = 0.99). The frequency of voluntary drop-out and treatment discontinuations due to adverse events was comparable between the patients with and without MMT [10 (12.3%) versus 14 (10.5%),
p
 = 0.68, and 4 (4.9%) versus 9 (6.8%),
p
 = 0.59, respectively]. The efficacy of HCV therapy in MMT patients is similar to that found in subjects not taking methadone. MMT patients should be equally considered for treatment with pegylated interferon plus ribavirin in HCV-infected patients.