HCV 血清阳性状态对阿片类药物依赖者丁丙诺啡药代动力学的影响。
Effects of HCV seropositive status on buprenorphine pharmacokinetics in opioid-dependent individuals.
机构信息
Department of Psychiatry, University of California, San Francisco, California.
出版信息
Am J Addict. 2014 Jan-Feb;23(1):34-40. doi: 10.1111/j.1521-0391.2013.12052.x. Epub 2013 Jun 10.
BACKGROUND AND OBJECTIVES
The purpose of this study was to examine the effect of hepatitis C virus (HCV) infection on buprenorphine pharmacokinetics in opioid-dependent, buprenorphine/naloxone-maintained adults.
METHODS
A retrospective analysis of buprenorphine pharmacokinetics in HCV seropositive and seronegative buprenorphine/naloxone-maintained individuals (N = 49) was undertaken.
RESULTS
Relative to HCV seronegative subjects, HCV seropositive subjects had higher buprenorphine exposure, as demonstrated by elevated buprenorphine AUC and Cmax values (p = .03 and .02, respectively) and corresponding elevations in the metabolites, buprenorphine-3-glucuronide AUC values (p = .03) and norbuprenorphine-3-glucuronide AUC and C24 values (p = .05 and .03, respectively).
DISCUSSION AND CONCLUSIONS
HCV infection was associated with higher plasma concentrations of buprenorphine and buprenorphine metabolites.
SCIENTIFIC SIGNIFICANCE AND FUTURE DIRECTIONS
Findings suggest the potential for opioid toxicity among HCV-infected patients treated with buprenorphine/naloxone, and possible hepatotoxic effects related to increased buprenorphine exposure. HCV-infected patients receiving buprenorphine may need lower doses to maintain therapeutic plasma concentrations.
背景和目的
本研究旨在探讨丙型肝炎病毒（HCV）感染对阿片类药物依赖、丁丙诺啡/纳洛酮维持治疗的成年人丁丙诺啡药代动力学的影响。
方法
对 HCV 血清阳性和血清阴性丁丙诺啡/纳洛酮维持治疗者（N=49）的丁丙诺啡药代动力学进行回顾性分析。
结果
与 HCV 血清阴性者相比，HCV 血清阳性者的丁丙诺啡暴露量更高，表现为丁丙诺啡 AUC 和 Cmax 值升高（p=.03 和.02），相应代谢物丁丙诺啡-3-葡萄糖醛酸 AUC 值（p=.03）和去甲丁丙诺啡-3-葡萄糖醛酸 AUC 和 C24 值（p=.05 和.03）升高。
讨论和结论
HCV 感染与丁丙诺啡和丁丙诺啡代谢物的血浆浓度升高有关。
科学意义和未来方向
研究结果表明，HCV 感染患者在接受丁丙诺啡/纳洛酮治疗时可能存在阿片类药物毒性的风险，以及与丁丙诺啡暴露增加相关的潜在肝毒性作用。接受丁丙诺啡治疗的 HCV 感染患者可能需要较低的剂量来维持治疗性血浆浓度。
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