Swiss Multicenter Study Evaluating the Efficacy, Feasibility and Safety of Peginterferon-Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C in Official Opiate Substitution Programs

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Original Paper

Swiss Multicenter Study Evaluating the Efficacy, Feasibility and Safety of

Peginterferon-Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C in

Official Opiate Substitution Programs

Frieda, e Monnatb, André Seidenbergc, Oppligerc,

Schmidd, Markus Herolde, Marc Islere, Barbara Broersf, Christoph Köllikerg,

Schönbucherh, Markus Freih, Milo Huberi

aGastroenterology and Hepatology, Private Practice, Basel,

bCentre Saint-, Lausanne,

cGeneral Medicine, Private Practice, Zurich,

dDivision of Infectious Diseases, Kantonsspital St. Gallen, St. Gallen,

eARUD (Arbeitsgemeinschaft für risikoarmen Umgang mit Drogen), Zurich,

fDivision of Primary Care Medicine, Department of Community Medicine and Primary

Care, University Hospitals, Genève,

gBADAL (Basler Drogenabgabelokal der ARUD), Basel,

hGeneral Medicine, Private Practice, Luzern, and

iDivision of Infectious Diseases, University Hospital, Zurich, Switzerland

Address of Corresponding Author

Digestion 2008;78:123-130 (DOI: 10.1159/000173733)

--------------------------------------------------------------------------------

Abstract

Background: Though patients in opiate substitution programs are commonly

infected with HCV, due to safety and efficacy concerns, they are rarely treated

with interferon and ribavirin. Methods: In a multicenter study, HCV-infected

patients in opiate maintenance treatment programs received 180 µg pegylated

interferon-alfa-2a once weekly, plus daily ribavirin for 24 weeks (genotypes 2,

3), or 48 weeks (genotypes 1, 4). Results: Of the 67 patients enrolled, 31 (46%)

had HCV genotypes 1 or 4, and 36 (54%) had genotypes 2 or 3. Intent-to-treat

analysis showed end-of-treatment virologic response in 75% of patients (81% of

genotypes 2 or 3; 65% of genotypes 1 or 4), and a sustained virologic response

in 61% of patients (72% of genotypes 2 or 3; 48% of genotypes 1 or 4). Fifteen

patients (22%) did not complete the study, in 5 (8%) cases because of severe

adverse events. Conclusions: Drug users with chronic HCV infection, regularly

attending an opiate maintenance program in which close collaboration between

hepatologists/internists and addiction specialists is assured, can be treated

effectively and safely with pegylated interferon-alfa-2a and ribavirin.

Treatment results are very similar to those in other patient groups, and thus

therapy

Author Contacts

Fried, MD

Burgunderstrasse 42

CH-4051 Basel (Switzerland)

Tel. +41 61 206 8686, Fax +41 61 206 8687

E-Mail rfried@...

--------------------------------------------------------------------------------

Article Information

Received: February 25, 2008

Accepted: August 18, 2008

Published online: November 21, 2008

[Guest guest]

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract & ArtikelNr=\

173733 & Ausgabe=241147 & ProduktNr=223838

Original Paper

Swiss Multicenter Study Evaluating the Efficacy, Feasibility and Safety of

Peginterferon-Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C in

Official Opiate Substitution Programs

Frieda, e Monnatb, André Seidenbergc, Oppligerc,

Schmidd, Markus Herolde, Marc Islere, Barbara Broersf, Christoph Köllikerg,

Schönbucherh, Markus Freih, Milo Huberi

aGastroenterology and Hepatology, Private Practice, Basel,

bCentre Saint-, Lausanne,

cGeneral Medicine, Private Practice, Zurich,

dDivision of Infectious Diseases, Kantonsspital St. Gallen, St. Gallen,

eARUD (Arbeitsgemeinschaft für risikoarmen Umgang mit Drogen), Zurich,

fDivision of Primary Care Medicine, Department of Community Medicine and Primary

Care, University Hospitals, Genève,

gBADAL (Basler Drogenabgabelokal der ARUD), Basel,

hGeneral Medicine, Private Practice, Luzern, and

iDivision of Infectious Diseases, University Hospital, Zurich, Switzerland

Address of Corresponding Author

Digestion 2008;78:123-130 (DOI: 10.1159/000173733)

--------------------------------------------------------------------------------

Abstract

Background: Though patients in opiate substitution programs are commonly

infected with HCV, due to safety and efficacy concerns, they are rarely treated

with interferon and ribavirin. Methods: In a multicenter study, HCV-infected

patients in opiate maintenance treatment programs received 180 µg pegylated

interferon-alfa-2a once weekly, plus daily ribavirin for 24 weeks (genotypes 2,

3), or 48 weeks (genotypes 1, 4). Results: Of the 67 patients enrolled, 31 (46%)

had HCV genotypes 1 or 4, and 36 (54%) had genotypes 2 or 3. Intent-to-treat

analysis showed end-of-treatment virologic response in 75% of patients (81% of

genotypes 2 or 3; 65% of genotypes 1 or 4), and a sustained virologic response

in 61% of patients (72% of genotypes 2 or 3; 48% of genotypes 1 or 4). Fifteen

patients (22%) did not complete the study, in 5 (8%) cases because of severe

adverse events. Conclusions: Drug users with chronic HCV infection, regularly

attending an opiate maintenance program in which close collaboration between

hepatologists/internists and addiction specialists is assured, can be treated

effectively and safely with pegylated interferon-alfa-2a and ribavirin.

Treatment results are very similar to those in other patient groups, and thus

therapy

Author Contacts

Fried, MD

Burgunderstrasse 42

CH-4051 Basel (Switzerland)

Tel. +41 61 206 8686, Fax +41 61 206 8687

E-Mail rfried@...

--------------------------------------------------------------------------------

Article Information

Received: February 25, 2008

Accepted: August 18, 2008

Published online: November 21, 2008

[Guest guest]

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract & ArtikelNr=\

173733 & Ausgabe=241147 & ProduktNr=223838

Original Paper

Swiss Multicenter Study Evaluating the Efficacy, Feasibility and Safety of

Peginterferon-Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C in

Official Opiate Substitution Programs

Frieda, e Monnatb, André Seidenbergc, Oppligerc,

Schmidd, Markus Herolde, Marc Islere, Barbara Broersf, Christoph Köllikerg,

Schönbucherh, Markus Freih, Milo Huberi

aGastroenterology and Hepatology, Private Practice, Basel,

bCentre Saint-, Lausanne,

cGeneral Medicine, Private Practice, Zurich,

dDivision of Infectious Diseases, Kantonsspital St. Gallen, St. Gallen,

eARUD (Arbeitsgemeinschaft für risikoarmen Umgang mit Drogen), Zurich,

fDivision of Primary Care Medicine, Department of Community Medicine and Primary

Care, University Hospitals, Genève,

gBADAL (Basler Drogenabgabelokal der ARUD), Basel,

hGeneral Medicine, Private Practice, Luzern, and

iDivision of Infectious Diseases, University Hospital, Zurich, Switzerland

Address of Corresponding Author

Digestion 2008;78:123-130 (DOI: 10.1159/000173733)

--------------------------------------------------------------------------------

Abstract

Background: Though patients in opiate substitution programs are commonly

infected with HCV, due to safety and efficacy concerns, they are rarely treated

with interferon and ribavirin. Methods: In a multicenter study, HCV-infected

patients in opiate maintenance treatment programs received 180 µg pegylated

interferon-alfa-2a once weekly, plus daily ribavirin for 24 weeks (genotypes 2,

3), or 48 weeks (genotypes 1, 4). Results: Of the 67 patients enrolled, 31 (46%)

had HCV genotypes 1 or 4, and 36 (54%) had genotypes 2 or 3. Intent-to-treat

analysis showed end-of-treatment virologic response in 75% of patients (81% of

genotypes 2 or 3; 65% of genotypes 1 or 4), and a sustained virologic response

in 61% of patients (72% of genotypes 2 or 3; 48% of genotypes 1 or 4). Fifteen

patients (22%) did not complete the study, in 5 (8%) cases because of severe

adverse events. Conclusions: Drug users with chronic HCV infection, regularly

attending an opiate maintenance program in which close collaboration between

hepatologists/internists and addiction specialists is assured, can be treated

effectively and safely with pegylated interferon-alfa-2a and ribavirin.

Treatment results are very similar to those in other patient groups, and thus

therapy

Author Contacts

Fried, MD

Burgunderstrasse 42

CH-4051 Basel (Switzerland)

Tel. +41 61 206 8686, Fax +41 61 206 8687

E-Mail rfried@...

--------------------------------------------------------------------------------

Article Information

Received: February 25, 2008

Accepted: August 18, 2008

Published online: November 21, 2008

[Guest guest]

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract & ArtikelNr=\

173733 & Ausgabe=241147 & ProduktNr=223838

Original Paper

Swiss Multicenter Study Evaluating the Efficacy, Feasibility and Safety of

Peginterferon-Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C in

Official Opiate Substitution Programs

Frieda, e Monnatb, André Seidenbergc, Oppligerc,

Schmidd, Markus Herolde, Marc Islere, Barbara Broersf, Christoph Köllikerg,

Schönbucherh, Markus Freih, Milo Huberi

aGastroenterology and Hepatology, Private Practice, Basel,

bCentre Saint-, Lausanne,

cGeneral Medicine, Private Practice, Zurich,

dDivision of Infectious Diseases, Kantonsspital St. Gallen, St. Gallen,

eARUD (Arbeitsgemeinschaft für risikoarmen Umgang mit Drogen), Zurich,

fDivision of Primary Care Medicine, Department of Community Medicine and Primary

Care, University Hospitals, Genève,

gBADAL (Basler Drogenabgabelokal der ARUD), Basel,

hGeneral Medicine, Private Practice, Luzern, and

iDivision of Infectious Diseases, University Hospital, Zurich, Switzerland

Address of Corresponding Author

Digestion 2008;78:123-130 (DOI: 10.1159/000173733)

--------------------------------------------------------------------------------

Abstract

Background: Though patients in opiate substitution programs are commonly

infected with HCV, due to safety and efficacy concerns, they are rarely treated

with interferon and ribavirin. Methods: In a multicenter study, HCV-infected

patients in opiate maintenance treatment programs received 180 µg pegylated

interferon-alfa-2a once weekly, plus daily ribavirin for 24 weeks (genotypes 2,

3), or 48 weeks (genotypes 1, 4). Results: Of the 67 patients enrolled, 31 (46%)

had HCV genotypes 1 or 4, and 36 (54%) had genotypes 2 or 3. Intent-to-treat

analysis showed end-of-treatment virologic response in 75% of patients (81% of

genotypes 2 or 3; 65% of genotypes 1 or 4), and a sustained virologic response

in 61% of patients (72% of genotypes 2 or 3; 48% of genotypes 1 or 4). Fifteen

patients (22%) did not complete the study, in 5 (8%) cases because of severe

adverse events. Conclusions: Drug users with chronic HCV infection, regularly

attending an opiate maintenance program in which close collaboration between

hepatologists/internists and addiction specialists is assured, can be treated

effectively and safely with pegylated interferon-alfa-2a and ribavirin.

Treatment results are very similar to those in other patient groups, and thus

therapy

Author Contacts

Fried, MD

Burgunderstrasse 42

CH-4051 Basel (Switzerland)

Tel. +41 61 206 8686, Fax +41 61 206 8687

E-Mail rfried@...

--------------------------------------------------------------------------------

Article Information

Received: February 25, 2008

Accepted: August 18, 2008

Published online: November 21, 2008