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Published on: April 16, 2019
Buprenorphine Induction in Persons With Opioid Use Disorder Hospitalized with Acute Hepatitis A
Devin A Oller1, Chase Thornton, Paul A Nuzzo
1Department of Medicine, Division of General Internal Medicine, University of Kentucky College of Medicine, (DAO, CT); Center for Drug and Alcohol Research, University of Kentucky College of Medicine, (PAN, LCF); Department of Medicine, Division of Infectious Diseases, University of Kentucky College of Medicine (LCF).
Background:
It is not known whether buprenorphine/naloxone (bup/nx) can be safely initiated in hospitalized patients with acute hepatitis A infection. We assessed liver function and tolerability of bup/nx induction in patients with acute Hepatitis A Virus (HAV).
Methods:
Retrospective review of patients (N = 31) admitted to a tertiary care facility for acute HAV who were evaluated by an addiction medicine consultant.
Results:
No significant difference was seen in aspartate aminotransferase, alanine aminotransferase, total bilirubin, or INR trends in patients receiving bup/nx during hospitalization versus those not receiving bup/nx. Nausea was the most common reported symptom in patients receiving bup/nx.
Discussion And Conclusions:
With careful monitoring and induction dose adjustment, bup/nx can be administered to patients with acute HAV without hepatic encephalopathy. Similarly, patients on bup/nx before hospitalization should not have this medication held in the setting of acute HAV.
Scientific Significance:
This strategy may engage patients with acute HAV in treatment of OUD earlier and minimize disruptions in treatment.
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