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

[Guest guest]

http://www3.interscience.wiley.com/journal/120751493/abstract

Journal of Viral Hepatitis

Volume 15 Issue 10, Pages 747 - 752

Published Online: 10 Jul 2008

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

sustained virological response rates in adherent patients

P. Bruggmann 1 , L. Falcato 1 , S. Dober 1 , B. Helbling 2 , O. Keiser 3 , F.

Negro 4 and D. Meili 1 on behalf of the Swiss Hepatitis C Cohort Study

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

2 Department of Gastroenterology and Hepatology, Stadtspital Waid, Zurich ; 3

SCCS Cohort Centre, University Hospital CHUV, Lausanne ; 4 Services de

Gastroentérologie et d'Hépatologie et de Pathologie Clinique, Hôpitaux

Universitaires, Genève, Switzerland

Correspondence to Philip Bruggmann, ARUD Zurich, Poliklinik Zokl1, Sihlhallenstr

30, CH 8026 Zurich, Switzerland. E-mail: p.bruggmann@...

ABSTRACT

Summary. 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.

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

Received January 2008; accepted for publication April 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2893.2008.01010.x

[Guest guest]

http://www3.interscience.wiley.com/journal/120751493/abstract

Journal of Viral Hepatitis

Volume 15 Issue 10, Pages 747 - 752

Published Online: 10 Jul 2008

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

sustained virological response rates in adherent patients

P. Bruggmann 1 , L. Falcato 1 , S. Dober 1 , B. Helbling 2 , O. Keiser 3 , F.

Negro 4 and D. Meili 1 on behalf of the Swiss Hepatitis C Cohort Study

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

2 Department of Gastroenterology and Hepatology, Stadtspital Waid, Zurich ; 3

SCCS Cohort Centre, University Hospital CHUV, Lausanne ; 4 Services de

Gastroentérologie et d'Hépatologie et de Pathologie Clinique, Hôpitaux

Universitaires, Genève, Switzerland

Correspondence to Philip Bruggmann, ARUD Zurich, Poliklinik Zokl1, Sihlhallenstr

30, CH 8026 Zurich, Switzerland. E-mail: p.bruggmann@...

ABSTRACT

Summary. 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.

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

Received January 2008; accepted for publication April 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2893.2008.01010.x

[Guest guest]

http://www3.interscience.wiley.com/journal/120751493/abstract

Journal of Viral Hepatitis

Volume 15 Issue 10, Pages 747 - 752

Published Online: 10 Jul 2008

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

sustained virological response rates in adherent patients

P. Bruggmann 1 , L. Falcato 1 , S. Dober 1 , B. Helbling 2 , O. Keiser 3 , F.

Negro 4 and D. Meili 1 on behalf of the Swiss Hepatitis C Cohort Study

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

2 Department of Gastroenterology and Hepatology, Stadtspital Waid, Zurich ; 3

SCCS Cohort Centre, University Hospital CHUV, Lausanne ; 4 Services de

Gastroentérologie et d'Hépatologie et de Pathologie Clinique, Hôpitaux

Universitaires, Genève, Switzerland

Correspondence to Philip Bruggmann, ARUD Zurich, Poliklinik Zokl1, Sihlhallenstr

30, CH 8026 Zurich, Switzerland. E-mail: p.bruggmann@...

ABSTRACT

Summary. 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.

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

Received January 2008; accepted for publication April 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2893.2008.01010.x

[Guest guest]

http://www3.interscience.wiley.com/journal/120751493/abstract

Journal of Viral Hepatitis

Volume 15 Issue 10, Pages 747 - 752

Published Online: 10 Jul 2008

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

sustained virological response rates in adherent patients

P. Bruggmann 1 , L. Falcato 1 , S. Dober 1 , B. Helbling 2 , O. Keiser 3 , F.

Negro 4 and D. Meili 1 on behalf of the Swiss Hepatitis C Cohort Study

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

2 Department of Gastroenterology and Hepatology, Stadtspital Waid, Zurich ; 3

SCCS Cohort Centre, University Hospital CHUV, Lausanne ; 4 Services de

Gastroentérologie et d'Hépatologie et de Pathologie Clinique, Hôpitaux

Universitaires, Genève, Switzerland

Correspondence to Philip Bruggmann, ARUD Zurich, Poliklinik Zokl1, Sihlhallenstr

30, CH 8026 Zurich, Switzerland. E-mail: p.bruggmann@...

ABSTRACT

Summary. 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.

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

Received January 2008; accepted for publication April 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2893.2008.01010.x