Active intravenous drug use during chronic hepatitis C therapy does not reduce sustained virological response rates in adherent patients

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J Viral Hepat. 2008 Jul 10. [Epub ahead of print]

Active intravenous drug use during chronic hepatitis C therapy does not reduce

sustained virological response rates in adherent patients.

Bruggmann P, Falcato L, Dober S, Helbling B, Keiser O, Negro F, Meili D; on

behalf of the Swiss Hepatitis C Cohort Study.

ARUD Zurich, Association for Risk Reduction in the Use of Drugs, Zurich,

Switzerland.

Reluctance has been expressed about treating chronic hepatitis C in active

intravenous (IV) drug users (IDUs), and this is found in both international

guidelines and routine clinical practice. However, the medical literature

provides no evidence for an unequivocal treatment deferral of this risk group.

We retrospectively analyzed the direct effect of IV drug use on treatment

outcome in 500 chronic hepatitis C patients enrolled in the Swiss Hepatitis C

Cohort Study. Patients were eligible for the study if they had their serum

hepatitis C virus (HCV) RNA tested 6 months after the end of treatment and at

least one visit during the antiviral therapy, documenting the drug use status.

Five hundred patients fulfilled the inclusion criteria (199 were IDU and 301

controls). A minimum exposure to 80% of the scheduled cumulative dose of

antivirals was reached in 66.0% of IDU and 60.5% of controls (P = NS). The

overall sustained virological response (SVR) rate was 63.6%. Active IDU reached

a SVR of 69.3%, statistically not significantly different from controls (59.8%).

A multivariate analysis for treatment success showed no significant negative

influence of active IV drug use. In conclusion, our study shows no relevant

direct influence of IV drugs on the efficacy of anti-HCV therapy among adherent

patients.

PMID: 18637072 [PubMed - as supplied by publisher]

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072008