Promoting Access to Hepatitis C Treatment via Integration with Methadone Maintenance Programs

Opioid-dependent patients who are infected with hepatitis C virus (HCV) should, but seldom do, receive HCV treatment. This retrospective observational study examined the feasibility and effectiveness of integrating HCV evaluation and treatment into a methadone maintenance treatment (MMT) program. Medical records of all patients who enrolled in MMT during the first 2 years of integrated HCV evaluation and treatment were reviewed (N=291). Of the 188 MMT patients (65%) who screened positive for HCV-antibody, 159 were eligible to receive further HCV evaluation and treatment based on insurance status,* and 125 accepted.

• Eighty-three (66%) patients were found to have chronic HCV infection, and 21 of 83 (25%) initiated treatment.

• Sustained virologic response (i.e., undetectable viral load 6 months following treatment) was achieved in 8 of 21 patients (38%) who initiated treatment.

• Seventeen patients had contraindications to HCV treatment, and 45 patients opted to forego or delay treatment, most commonly due to personal choice (29 of 45 patients).

Comments:

This small retrospective study demonstrates the feasibility of integrating HCV care with MMT programs. Treatment outcomes among HCV patients in this sample were comparable to those of other published studies. Although the results are encouraging, further evaluation using an off-site comparator group would lend further support to this model of care.

Jeanette M. Tetrault, MD

Reference:

Harris KA, Arnsten JH, Litwin AH. Successful integration of hepatitis C evaluation and treatment services with methadone maintenance. J Addict Med. 2010;4(1):20–26.