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.
