Treatment for chronic hepatitis C in a cohort of opiate substitution therapy recipients in three Swedish cities - completion rates and efficacy

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Treatment for chronic hepatitis C in a cohort of opiate substitution therapy recipients in three Swedish cities - completion rates and efficacy

Jerkeman, A. (author)

Norkrans, Gunnar, 1944 (author): Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine

Lidman, C. (author)

Westin, Johan, 1965 (author): Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine

Lagging, Martin, 1965 (author): Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine

Frimand, J. (author)

Simonsberg, C. (author)

Kakko, J. (author)

Widell, A. (author)

Bjorkman, P. (author)

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(creator_code:org_t)

Ovid Technologies (Wolters Kluwer Health), 2014
2014
English.
In: European Journal of Gastroenterology & Hepatology. - : Ovid Technologies (Wolters Kluwer Health). - 0954-691X. ; 26:5, s. 523-531

Related links:: https://gup.ub.gu.se...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objectives Opiate substitution treatment (OST) programs could provide opportunities for management of comorbidities, such as hepatitis C virus (HCV) infection, in people who inject drugs. We aimed to prospectively evaluate the real-life feasibility of interferon/ribavirin-based HCV treatment in OST recipients, with a special focus on psychiatric status and health-related quality of life. Patients from a cohort of OST recipients from three cities in Sweden were selected for HCV treatment on the basis of structured investigation for HCV-related liver disease. Therapy was delivered in collaboration between infectious disease and OST clinics, with monitoring for completion and adherence, treatment response, adverse events, health-related quality of life (HRQoL) (SF-36) and signs of depression (MADRS-S), or relapse into drug abuse. The primary endpoint was completion of prescribed treatment; the secondary endpoints were sustained virological response (SVR), adherence, and incidence of depression. Among 69 patients with an indication for antiviral therapy, 41 initiated treatment; 34/41 (83%) completed treatment and 19/41 (46%) achieved SVR. Adequate adherence was observed in 29/41 patients (71%). Two serious adverse events occurred, including one death because of liver failure. Baseline scores for self-assessed health were low, with a significant reduction during treatment. Seventy-one percent of patients (29/41) fulfilled the criteria for clinically significant depression at some time point during treatment. Baseline scores for HRQoL/MADRS-S were associated with treatment completion, SVR, and depression during treatment. Despite the low HRQoL and the high occurrence of depression, HCV treatment was feasible and showed satisfactory rates of completion in this cohort of unselected OST recipients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)

Keyword

hepatitis C
treatment completion
opiate substitution
depression
health-related quality of life
INJECTION-DRUG USERS
RIBAVIRIN COMBINATION THERAPY
HEALTH SURVEY
QUESTIONNAIRE
ALPHA-2A PLUS RIBAVIRIN
LIVER-RELATED MORTALITY
QUALITY-OF-LIFE
VIRUS-INFECTION
RANDOMIZED-TRIAL
HCV INFECTION

Publication and Content Type

ref (subject category)
art (subject category)

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By the author/editor: Jerkeman, A.; Norkrans, Gunnar ...; Lidman, C.; Westin, Johan, 1 ...; Lagging, Martin, ...; Frimand, J.; show more...; Simonsberg, C.; Kakko, J.; Widell, A.; Bjorkman, P.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Gastroenterology ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Infectious Medic ...

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By the university: University of Gothenburg

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