Background: Injection drug users (IDUs) represent a significant proportion of patients with chronic hepatitis C\r\n(CHC). The low treatment uptake among these patients results in a low treatment effectiveness and a limited public\r\nhealth impact. We hypothesised that a general practitioner (GP) providing an opioid maintenance treatment (OMT)\r\nfor addicted patients can achieve CHC treatment and sustained virological response rates (SVR) comparable to\r\npatients without drug dependency.\r\nMethods: Retrospective patient record analysis of 85 CHC patients who received OMT for more than 3 months in a\r\nsingle-handed general practice in Zurich from January 1, 2002 through May 31, 2008. CHC treatment was based on\r\na combination with pegylated interferon and ribavirin. Treatment uptake and SVR (undetectable HCV RNA 6 months\r\nafter end of treatment) were assessed. The association between treatment uptake and patient characteristics was\r\ninvestigated by multiple logistic regression.\r\nResults: In 35 out of 85 CHC patients (52 males) with a median (IQR) age of 38.8 (35.0-44.4) years, antiviral therapy\r\nwas started (41.2%). Median duration (IQR) of OMT in the treatment group was 55.0 (35.0-110.1) months compared\r\nto the group without therapy 24.0 (9.8-46.3) months (p<0.001). OMT duration remained a significant determinant\r\nfor treatment uptake when controlled for potential confounding. SVR was achieved in 25 out of 35 patients (71%).\r\nConclusion: In addicted patients a high CHC treatment and viral eradication rate in a primary care setting in\r\nSwitzerland is feasible. Opioid substitution seems a beneficial framework for CHC care in this ââ?¬Å?difficult to treatââ?¬Â\r\npopulation.
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