Active Injection Drug Use Does Not Impair Sustained Response to Hepatitis C Treatment
in Adherent Patients By
Liz Highleyman  Chronic
hepatitis C virus (HCV) infection is common among injection
drug users (IDUs) since the virus is readily transmitted through shared needles
and other drug use equipment.
Many clinicians, however, are reluctant to
offer hepatitis C treatment to IDUs who continue active drug use, due to concerns
such as poor adherence and increased risk of interferon-induced psychiatric side
effects such as depression.
In the July 10 advance online edition of the
Journal of Viral Hepatitis, Philip Bruggmann from the Association for Risk
Reduction in the Use of Drugs in Zurich, Switzerland and colleagues reported results
from a study of hepatitis C treatment in active drug users. As background, the
authors noted that the medical literature provides no evidence for an unequivocal
treatment deferral of active IDUs.
The investigators retrospectively analyzed
the direct effect of injection drug use on treatment outcomes in 500 chronic hepatitis
C patients enrolled in the Swiss Hepatitis C Cohort Study. Individuals were eligible
for the study if they had at least 1 visit while receiving antiviral therapy documenting
drug use status and an HCV RNA test 6 months after the end of treatment to assess
sustained virological response (SVR). A total of 500 participants fulfilled the
inclusion criteria: 199 IDUs and 301 non-drug-using control subjects.
Results
•
66.0% of IDUs and 60.5% of control subjects attained a minimum exposure to at
least 80% of the scheduled cumulative dose of antiviral medications (a statistically
non-significant difference).
•
The overall SVR rate was 63.6%, and rates
were not significantly different in the 2 groups:
•
Active IDUs: 69.3%;
•
Non-drug-using control subjects: 59.8%.
•
A multivariate analysis for treatment success showed no significant negative influence
of active injection drug use.
In
conclusion, the authors wrote, "our study shows no relevant direct influence
of IV drugs on the efficacy of anti-HCV therapy among adherent patients."
7/22/08
Reference
P
Bruggmann, L Falcato, S Dober, and others. Active intravenous drug use during
chronic hepatitis C therapy does not reduce sustained virological response rates
in adherent patients. Journal of Viral Hepatitis. July 10, 2008 [Epub ahead
of print]. |
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