Abstract
Aims: To evaluate the efficacy, safety and adherence to hepatitis C (HCV) therapy in patients attending tertiary hepatitis clinics who are receiving opioid replacement therapy
Design: A non-randomised, open-label study . Participants were treated with pegylated interferon alfa-2a and weight-based ribavirin for 24 weeks (genotype non–1, n=31) or 48 weeks (genotype 1, n=22).
Setting: Four tertiary hospital hepatitis clinics in Australia.
Participants: Fifty-three patients with chronic HCV who were receiving opioid replacement therapy
Measurements: Patients were monitored for virological response, adverse events and adherence. They were also screened for psychiatric illness prior to and throughout the study utilising 2 validated instruments: the MINI and BDI-II.
Findings: The overall sustained virological response (SVR) rate was 57% (71% genotype non-1 vs. 36% genotype 1), and was similar in active injectors (63%) and non-injectors (53%). The psychological profile of patients based on validated instruments did not change on therapy. The pattern and frequency of AEs were comparable to non-opioid replacement patients. Eighty-five percent of patients were adherent to therapy by 80/80/80 criteria and only 2 patients who had an end of treatment response relapsed, one of whom was not an active injector.
Conclusions: patients on opioid replacement therapy, even if they continue to actively inject, can achieve comparable SVR rates to other populations with pegylated interferon alfa-2a and ribavirin therapy, suffer no excess rates of AEs or psychological complications and have good adherence to therapy