Z Gastroenterol 2012; 50 - A46
DOI: 10.1055/s-0032-1312400

HCV infection in intravenous drug users: Results of the antiviral therapy and the questions of the compliance

B Lombay 1, F Szalay 2
  • 1Borsod County Hospital, Department of St. Ferenc Hospital, Department of Medicine and Gastroenterology, Miskolc
  • 21st Clinic of Medicine, Semmelweis University, Budapest

Background: Intravenous drug use, tattoo and piercing are recently the most important pathways in the spreading of hepatitis C virus (HCV) infection. Screening for anti-HCV, hepatitis B virus and HIV in intravenous drug users (IDUs) are available in Hungarian Drug Outpatient Clinics. The prevalence of anti-HCV in IDUs is high (60–80%) worldwide and shows a relatively low (20–22%) value in Hungary.

Aim: We analyzed the prevalence of IDU in our chronic hepatitis C (CHC) patients and the rate of sustained virological response (SVR) in IDUs by pegylated interferon (PEG-IFN) and ribavirin (RBV) therapy from 2006 to 2012.

Patients and methods: Twenty CHC patients (17 male/3 female; all HCV genotype 1) were previously IDUs (11% of total CHC subjects). All of the former IDU patients had indication for antiviral therapy; nine of them disappeared in the screening period or after the beginning of the treatment. The studied eleven patient's mean age was 30.6±6.6 (18–37) years, mean body weight 65.6±7.8kg; mean baseline viral load 377500 IU/ml, mean baseline ALT 59.15±13.25U/l. Nine patients were treated with PEG-IFN and RBV for 24 or 48 weeks and one patient had PEG-IFN monotherapy for 24 weeks. Antiviral therapy of two subjects had not finished yet. Four patients had oral methadone therapy during the antiviral treatment.

Results: Everyone (9/9) from the IDUs achieved SVR, who completed the antiviral treatment. Two on-treatment patients had complete early virological response (cEVR) on week 12 of the therapy. There was no need for reduction of the administered antiviral drugs.

Conclusion: IDU patients with appropriate adherence and compliance have very good chances for the curing by antiviral therapy. Low baseline viral load, achieving cEVR, young age, subacute period of infection and treatment-naïve status are good predictors for SVR. Education programs for primary prevention of HCV infection for IDUs are very important.