Guadagnino, Vincenzo and Trotta, Maria Paola and Montesano, Franco and Babudieri, Sergio and Caroleo, Benedetto and Armignacco, Orlando and Carioti, Jessica and Maio, Giuseppe and Monarca, Roberto and Antinori, Andrea (2006) 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 (3), p. 423-431. eISSN 1360-0443. Article.
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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 a-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 amulti-disciplinary standardized management model helps many HCV-positive drug addicts achieve a good virological response.
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