Patients with drug addiction can be treated with HCV drug: Study
The opioid problem in America is a major cause of common blood-borne infection hepatitis C virus (HCV), with the disease spreading to nearly 3 million people in the country, says the Centers for Disease Control and Prevention (CDC). This can be attributed to high exposure to contaminated blood, with injection drug use (IDU) being the most important risk factor. It is a common perception that patients of chronic hepatitis C virus (HCV) with a recent history of drug use cannot be cured with the treatment for HCV.
However, a recent study, published in the Annals of Internal Medicine in August 2016, suggested that a combination drug (elbasvir/grazoprevir) can effectively bring down the viral infection in patients suffering from chronic HCV who have been receiving treatment for opioid addiction.
Addiction treatment and curative therapies can tackle HCV
The study, led by Gregory J. Dore, M.B.B.S., Ph.D., F.R.A.C.P., M.P.H., University of New South Wales in Sydney, and colleagues, claimed that the combination therapy can be an effective way to treat patients with HCV infection who are administered opioid agonist therapy. Opioid addicts do not have an easy access to treatment even though HCV infection is highly predominant in such a population.
As per a report by the Medscape Medical News, the drug has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic HCV genotypes (GTs) 1 and 4 infections. “Coupling addiction treatment and curative HCV therapies has been predicted to reduce overall transmission and burden of this deadly infection,” said Arthur Y. Kim, M.D., director of Viral Hepatitis Clinic at Massachusetts General Hospital in Boston.
Thus, the discovery of the efficacy of the combination drug will shake off the myth that people who abuse opioids cannot be treated for HCV.
Treatment adherence major concern in patients using drugs
For the study, the researchers examined 301 patients, enrolled between September 2014 and December 2014, suffering from chronic HCV GT 1, GT 4, or GT 6, who adhered to opioid antagonist therapy. Among those enrolled, 20.6 percent suffered from cirrhosis and 7 percent experienced an HIV coinfection. Moreover, 79.4 percent were undergoing methadone treatment and 20.3 percent were administered buprenorphine at baseline.
Of the total, 201 were treated with the combination medication for 12 weeks, while the remaining participants were given a placebo for 12 weeks. A follow-up after four weeks was followed by open-label therapy with the combination drug which lasted 12 weeks.
The results revealed that 91.5 percent patients in the treatment group showed a sustained virologic response at the end of week 12, which was similar to the response seen in 89.5 percent patients in the active phase of delayed treatment protocol. Moreover, a significant virologic response was found in patients who suffered from cirrhosis and those whose urine tested positive for drug, while worst outcomes were observed among patients of Asian origin.
Overall, the treatment was found to be well-tolerated by the participants, with 3.5 percent patients in the immediate treatment group and 4 percent of the delayed treatment group experiencing serious adverse outcomes. In fact, the patients showed excellent adherence to treatment, a tendency usually not seen in patients who use drugs. Moreover, an ongoing drug use did not impact the efficacy of the treatment, said the researchers.
However, of the six patients who encountered reinfections, four were found to use opioids, confirming that the infections were a result of injection drug use. Thus, the researchers intend to conduct a further study to evaluate drug use pattern and HCV reinfection in patients.
Road to recovery
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