In the United States, hepatitis C virus (HCV) is the leading cause of liver failure and the main risk factor is injection drug use. Opioid agonist treatment in the form of methadone or buprenorphine is the most effective treatment for opioid use disorder. Researchers investigated characteristics associated with successful treatment for HCV among a cohort of patients in New York City who received buprenorphine treatment in primary care.
- Of 390 patients who initiated buprenorphine treatment between 2009 and 2014, 123 (32%) were found to have chronic HCV infection.
- Of those with chronic HCV infection, 52% were referred for treatment, 33% had an HCV-specific evaluation, 17% were offered treatment, and 8% initiated treatment. Of the 10 patients who initiated treatment, 7 achieved cure.
- Compared with those who did not, patients who remained in buprenorphine treatment for ≥6 months were more likely: to be referred for HCV specialty care (63% versus 34%); to receive HCV-specific evaluation (41% versus 21%); to be offered HCV treatment (22% versus 9%); and to initiate treatment (9% versus 6%).
Comments: This study shows how buprenorphine treatment can facilitate the identification and treatment of other chronic medical problems. Treatment outcomes would likely have been improved further by providing HCV-specific evaluation and treatment at the buprenorphine treatment site.
Darius A. Rastegar, MD
Reference: Norton BL, Beitin A, Glenn M, et al. Retention in buprenorphine treatment is associated with improved HCV care outcomes. J Subst Abus Treat. 2017;75:38–42.