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Intravenous Drug Users Can Achieve a High Sustained Virological Response Rate: experience From Croatian Reference

Ivan Kurelac1, Neven Papic, Slavko Sakoman

  • 1Croatian Reference Center for Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia.

Hepatitis Monthly
|February 28, 2012
PubMed

Insights

Treatment for Hepatitis C virus (HCV) in injecting drug users (IDUs) should be encouraged. IDUs showed higher sustained virologic response (SVR) rates and good adherence, with no significant differences in safety or tolerability compared to non-IDUs.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Addiction Medicine

Background:

  • Hepatitis C virus (HCV) significantly impacts injecting drug users (IDUs), yet many remain untreated.
  • Understanding treatment outcomes in IDUs is crucial for public health interventions.

Purpose of the Study:

  • To compare treatment course, adherence, tolerability, safety, and sustained virologic response (SVR) rates of PEG-IFN-α and ribavirin in HCV-infected IDUs versus non-IDUs.
  • To identify predictors of successful treatment outcomes in chronic hepatitis C (CHC).

Main Methods:

  • Retrospective analysis of 345 CHC patients treated with PEG-IFN-α and ribavirin (2003-2010).
  • Comparison of efficacy, safety, and tolerability profiles between IDUs and non-IDUs.
  • Univariate and multivariate logistic regression to evaluate predictors of SVR.

Main Results:

  • IDUs (30.46%) were younger, predominantly male, with less fibrosis and shorter infection duration than non-IDUs.
  • IDUs achieved significantly higher overall SVR rates (70.75% vs. 51.04%) and for genotypes 1 and 4.
  • No significant differences in treatment completion or discontinuation due to side-effects were observed; however, IDUs had higher lost-to-follow-up rates.

Conclusions:

  • CHC treatment in IDUs is highly recommended due to favorable predictors like younger age, shorter infection duration, and good adherence.
  • IDUs exhibit comparable safety and tolerability profiles to non-IDUs during HCV treatment.
  • Age under 40 and genotypes 2/3 were independent predictors of SVR.
Abstract

Keywords:
AddictiveBehaviorChronicHepatitisHepatitis CInfusions, IntravenousInjections

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