Twenty-five recovering drug users (DUs) with active hepatitis C virus (HCV)in stable recovery on methadone were treated with Rebetron at standard dosing regimens. Enrollment was based on active disease as determined by positive RNA PCR, and surrogate markers of fibrosis; splenomegaly, declining platelet count, hypoalbuminemia, and/or elevated PT. The average age was 49 +/-8; 56% were male; 72% Caucasian, 16% African-American, and 12% Latino. Sixty percent had stable pre-existing psychiatric diagnosis, with depression (44%) the most common. The most common side effects were influenza-like symptoms in 64% (14/25), psychiatric symptoms in 36% (9/25), and GI symptoms in 32% (8/25). Twenty percent (5/25) required dose reduction due to anemia or other adverse events, 12% (3/25) required a minimal increase in methadone dosing, and 8% (2/25) discontinued treatment. There was no resumption of illicit substance use, and there were no serious events. Against historical controls, these preliminary data suggest that recovering DUs on methadone, despite pre-existing psychiatric disorders, tolerate and can safely comply with Rebetron treatment as compared to the general population with HCV.
Learning Objectives: 1. Develop new approaches to HCV treatment medication adherence issues for persons in substance abuse treatment settings. 2. Analyze the role of patient support groups and buddy systems for HCV treatment management. 3. Discuss better symptom management techniques for HCV treatment of drug users, drawing from lessons learned in HIV treatment
Keywords: Hepatitis C, Methadone Maintenance
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Schering Oncology Biotech, Schering Plough Corporation: Rebetron Product Sector
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: My agency, OASIS, currently has a small grant for patient education with Schering Plough. I, along with my co-authors, currently have a grant application under review by Schering Plough, to fund a pilot Rebetron treatment program in four methadone mainten