Murphy Sean M, Dweik Dana, McPherson Sterling, Roll John M
Department of Health Policy and Administration, Washington State University , Spokane, Washington , USA .
Am J Drug Alcohol Abuse. 2015 Jan;41(1):88-92. doi: 10.3109/00952990.2014.983274.
The prevalence of hepatitis-C-virus (HCV) infections is high among opioid-dependent individuals. Prior research on the simultaneous treatment of both conditions has primarily assessed success as it pertains to HCV. However, it has been noted that favorable substance use therapy outcomes may improve the likelihood of HCV-treatment initiation and success. Therefore, current guidelines for the treatment of HCV among illicit drug users suggest that treatment for addiction be given the highest priority.
To determine whether opioid-dependent participants in a clinical trial of buprenorphine-treatment tapering regimens, who tested positive for the HCV antibody, experienced significantly different levels of opioid abstinence than those not infected.
Data came from the National Drug Abuse Treatment Clinical Trial Network study 0003. 516 eligible opioid-dependent participants were randomized to either a 7-day or 28-day buprenorphine tapering schedule following a 4-week buprenorphine stabilization period. Generalized estimating equations were used to test the research question.
Participants with the HCV antibody were significantly less likely to submit opioid-negative urine analyses during and/or immediately following active treatment [OR = 0.69; CI = 0.51-0.93], indicating a higher rate of opioid use among this group.
Individualized opioid-dependence treatment strategies may be required for opioid-dependent individuals who test positive for the HCV antibody in order to ensure resources for both opioid-dependence and HCV therapies are used efficiently.
丙型肝炎病毒(HCV)感染在阿片类药物依赖者中很常见。先前关于同时治疗这两种疾病的研究主要评估了与HCV相关的治疗成功率。然而,已经注意到良好的物质使用治疗结果可能会提高启动和成功进行HCV治疗的可能性。因此,目前针对非法药物使用者的HCV治疗指南建议将成瘾治疗放在最优先的位置。
确定在丁丙诺啡治疗减量方案的临床试验中,HCV抗体检测呈阳性的阿片类药物依赖参与者与未感染者相比,在阿片类药物戒断水平上是否存在显著差异。
数据来自国家药物滥用治疗临床试验网络研究0003。516名符合条件的阿片类药物依赖参与者在经过4周的丁丙诺啡稳定期后,被随机分配到7天或28天的丁丙诺啡减量方案中。使用广义估计方程来检验研究问题。
在积极治疗期间和/或治疗后立即进行阿片类药物阴性尿液分析的HCV抗体阳性参与者的可能性显著降低[OR = 0.69;CI = 0.51 - 0.93],表明该组阿片类药物使用率较高。
对于HCV抗体检测呈阳性的阿片类药物依赖个体,可能需要个体化的阿片类药物依赖治疗策略,以确保有效利用阿片类药物依赖和HCV治疗的资源。