Historique
Périodique
Hepatitis C virus eradication in intravenous drug users maintained with subcutaneous naltrexone implants
(L'éradication du virus de l'hépatite C chez les toxicomanes injecteurs substitués avec des implants sous-cutanés de naltrexone.)
Auteur(s) :
JEFFREY G. P. ;
MACQUILLAN G. ;
CHUA F. ;
GALHENAGE S. ;
BULL J. ;
E. YOUNG ;
G. HULSE ;
G. O'NEIL
Article en page(s) :
111-117
Refs biblio. :
34
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Français
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus mots-clés
HEPATITE
;
VIRUS
;
NALTREXONE
;
TRAITEMENT DE MAINTENANCE
;
INJECTION
;
ANTIVIRAUX
;
EFFICACITE
Thésaurus géographique
AUSTRALIE
Note générale :
Hepatology, 2007, 45, (1), 111-117
Editorial p.3-5 : "Enhancing hepatitis C treatment uptake and outcomes for injection drug users", Dore G.J.
Letter to the Editor : "Hepatitis C treatment, subcutaneous naltrexone implants, and methadone maintenance treatment", Novick D.M., Kreek M.J., Hepatology 2007;46(3):951-952.
Editorial p.3-5 : "Enhancing hepatitis C treatment uptake and outcomes for injection drug users", Dore G.J.
Letter to the Editor : "Hepatitis C treatment, subcutaneous naltrexone implants, and methadone maintenance treatment", Novick D.M., Kreek M.J., Hepatology 2007;46(3):951-952.
Résumé :
ENGLISH :
The effectiveness of HCV antiviral therapy in patients who have undergone recent drug dependency treatment and continue to inject drugs sporadically is presently not clear. Patients attending a community-based drug rehabilitation and naltrexone implant clinic from October 2002 until March 2005 were screened for HCV infection and if positive offered further assessment and treatment with interferon and ribavirin therapy. The first 50 patients to commence HCV therapy and complete at least 6 months follow-up were prospectively studied. ETR response (HCV PCR negative) was 34/50 (68%) and SVR 6 months post-treatment was 31/50 (62%). Viral eradication was maintained in those 22 patients that have had 12 months or more post-treatment follow-up. Eleven (22%) patients stopped therapy early due to side effects or poor compliance. Only two patients with an ETR likely reinfected due to unsafe injection practices. One was re-treated and achieved an SVR. Of the patients achieving a 6-month SVR, 17 of 31 patients reported no further IDU and 13 of 31 patients occasional IDU during treatment and this was maintained after HCV treatment cessation. 46% of patients received antidepressant and/or antipsychotic medication during treatment. CONCLUSION: This study of HCV treatment in a community-based subcutaneous naltrexone implant clinic found antiviral therapy resulted in a 62% SVR. This result is comparable to that reported in hospital-based clinics in non-IDU patients. The side effect profile and compliance was also similar. HCV antiviral therapy should be offered to this large and currently under treated group. (Author' s abstract)
ENGLISH :
The effectiveness of HCV antiviral therapy in patients who have undergone recent drug dependency treatment and continue to inject drugs sporadically is presently not clear. Patients attending a community-based drug rehabilitation and naltrexone implant clinic from October 2002 until March 2005 were screened for HCV infection and if positive offered further assessment and treatment with interferon and ribavirin therapy. The first 50 patients to commence HCV therapy and complete at least 6 months follow-up were prospectively studied. ETR response (HCV PCR negative) was 34/50 (68%) and SVR 6 months post-treatment was 31/50 (62%). Viral eradication was maintained in those 22 patients that have had 12 months or more post-treatment follow-up. Eleven (22%) patients stopped therapy early due to side effects or poor compliance. Only two patients with an ETR likely reinfected due to unsafe injection practices. One was re-treated and achieved an SVR. Of the patients achieving a 6-month SVR, 17 of 31 patients reported no further IDU and 13 of 31 patients occasional IDU during treatment and this was maintained after HCV treatment cessation. 46% of patients received antidepressant and/or antipsychotic medication during treatment. CONCLUSION: This study of HCV treatment in a community-based subcutaneous naltrexone implant clinic found antiviral therapy resulted in a 62% SVR. This result is comparable to that reported in hospital-based clinics in non-IDU patients. The side effect profile and compliance was also similar. HCV antiviral therapy should be offered to this large and currently under treated group. (Author' s abstract)
Affiliation :
School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia. Email : gjeffrey@cyllene.uwa.edu.au
Australie. Australia.
Australie. Australia.
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