Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes

Vincenzo Guadagnino, Maria Paola Trotta, Franco Montesano, Sergio Babudieri, Benedetto Caroleo, Orlando Armignacco, Jessica Carioti, Giuseppe Maio, Roberto Monarca, Andrea Antinori

Research output: Contribution to journalArticle

Abstract

Aim: To evaluate the effect of a multi-disciplinary standardized management model on the efficacy of pegylated (Peg)-interferon α-2b plus ribavirin treatment of chronic hepatitis C in drug addicts undergoing substitutive or antagonist therapy. Design: Observational prospective multi-centre study. Setting: Six clinical infectious disease centres in collaboration with 11 drug dependency units (DDU) in five Italian regions. Participants: Intravenous drug users affected by chronic hepatitis C engaged in detoxification programmes. Methods: Application of a multi-disciplinary standardized management model for HCV treatment involving DDU operators, psychologists or psychiatrists and infectious disease specialists. Measurements: Very early, early, end-of-treatment and sustained virological response to Peg-interferon α-2b plus ribavirin. Findings: Fifty-three subjects were studied [43.4% with hepatitis C virus (HCV) genotypes 1 or 4]. Intent-to-treat analysis showed an end-of-treatment virological response in 58.5% of patients (39.1% genotypes 1 or 4; 73.4% genotype 3) and a sustained virological response in 54.7% (34.8% genotypes 1 or 4; 70.0% genotype 3). There were 19 (35.8%) dropouts and three (5.7%) non-responders: one genotype 1 and two genotype 4. Two (3.8%) patients relapsed: genotypes 1 and 3. On-treatment analysis showed negative HCV-RNA in 40 (93.1%) of 43 subjects who completed the first 12 treatment weeks and in 35 who completed the first 24 treatment weeks. All subjects with an end-of-treatment response, except one with genotype 3 infection, had a sustained response. Conclusions: Our data show that antiviral treatment in the context of a multi-disciplinary standardized management model helps many HCV-positive drug addicts achieve a good virological response.

Original languageEnglish
Pages (from-to)423-431
Number of pages9
JournalAddiction
Volume102
Issue number3
DOIs
Publication statusPublished - Mar 2007

Fingerprint

Chronic Hepatitis C
Drug Users
Genotype
Hepacivirus
Therapeutics
Ribavirin
Interferons
Communicable Diseases
Pharmaceutical Preparations
Antiviral Agents
Psychiatry
RNA
Psychology

Keywords

  • HCV infection
  • Intravenous drug use
  • Management of hepatitis C
  • Peg interferon

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes. / Guadagnino, Vincenzo; Trotta, Maria Paola; Montesano, Franco; Babudieri, Sergio; Caroleo, Benedetto; Armignacco, Orlando; Carioti, Jessica; Maio, Giuseppe; Monarca, Roberto; Antinori, Andrea.

In: Addiction, Vol. 102, No. 3, 03.2007, p. 423-431.

Research output: Contribution to journalArticle

Guadagnino, V, Trotta, MP, Montesano, F, Babudieri, S, Caroleo, B, Armignacco, O, Carioti, J, Maio, G, Monarca, R & Antinori, A 2007, 'Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes', Addiction, vol. 102, no. 3, pp. 423-431. https://doi.org/10.1111/j.1360-0443.2006.01698.x
Guadagnino, Vincenzo ; Trotta, Maria Paola ; Montesano, Franco ; Babudieri, Sergio ; Caroleo, Benedetto ; Armignacco, Orlando ; Carioti, Jessica ; Maio, Giuseppe ; Monarca, Roberto ; Antinori, Andrea. / Effectiveness of a multi-disciplinary standardized management model in the treatment of chronic hepatitis C in drug addicts engaged in detoxification programmes. In: Addiction. 2007 ; Vol. 102, No. 3. pp. 423-431.
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abstract = "Aim: To evaluate the effect of a multi-disciplinary standardized management model on the efficacy of pegylated (Peg)-interferon α-2b plus ribavirin treatment of chronic hepatitis C in drug addicts undergoing substitutive or antagonist therapy. Design: Observational prospective multi-centre study. Setting: Six clinical infectious disease centres in collaboration with 11 drug dependency units (DDU) in five Italian regions. Participants: Intravenous drug users affected by chronic hepatitis C engaged in detoxification programmes. Methods: Application of a multi-disciplinary standardized management model for HCV treatment involving DDU operators, psychologists or psychiatrists and infectious disease specialists. Measurements: Very early, early, end-of-treatment and sustained virological response to Peg-interferon α-2b plus ribavirin. Findings: Fifty-three subjects were studied [43.4{\%} with hepatitis C virus (HCV) genotypes 1 or 4]. Intent-to-treat analysis showed an end-of-treatment virological response in 58.5{\%} of patients (39.1{\%} genotypes 1 or 4; 73.4{\%} genotype 3) and a sustained virological response in 54.7{\%} (34.8{\%} genotypes 1 or 4; 70.0{\%} genotype 3). There were 19 (35.8{\%}) dropouts and three (5.7{\%}) non-responders: one genotype 1 and two genotype 4. Two (3.8{\%}) patients relapsed: genotypes 1 and 3. On-treatment analysis showed negative HCV-RNA in 40 (93.1{\%}) of 43 subjects who completed the first 12 treatment weeks and in 35 who completed the first 24 treatment weeks. All subjects with an end-of-treatment response, except one with genotype 3 infection, had a sustained response. Conclusions: Our data show that antiviral treatment in the context of a multi-disciplinary standardized management model helps many HCV-positive drug addicts achieve a good virological response.",
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