Methadone, Opioid Therapy for Injection-drug Users Found to Reduce HCV Infection

Methadone, Opioid Therapy for Injection-drug Users Found to Reduce HCV Infection

methadoneA new study on the effect of opioid agonist therapy in HCV infection entitled “Association of Opioid Agonist Therapy With Lower Incidence of Hepatitis C Virus Infection in Young Adult Injection Drug Users” was published on JAMA Internal Medicine by Judith I. Tsui, M.D., M.P.H., of the Boston University School of Medicine, and colleagues.

Hepatitis C virus (HCV) infection is transmitted mainly by the use of drugs injected intravenously. Younger drug addicts are the main target group for HCV infection, and for this reason, all types of intervention to prevent these infections is crucial. Previous studies have suggested that opioid agonist therapy (methadone hydrochloride or buprenorphine hydrochloride) may reduce the frequency of HCV infection among injection drug addicts, but its effects in younger users have not been addressed. Therefore, in this study, Dr. Judith I. Tsui and colleagues addressed if opioid agonist therapy was associated with a lower incidence of HCV infection in a cohort of young adult injection drug users.

The research team performed an observational cohort study during a time period from January 3, 2000, to August 21, 2013, by doing periodical interviews and blood sampling. In this study, the researchers enrolled 552 young adults  30 years and younger that were injection drug users and were negative for the anti-HCV antibody and/or HCV RNA. The average age of the subjects was 23 years, the majority was male, white, and homeless, and the median duration of drug utilization was 3.6 years. 33.3 % of them used drugs daily. Heroin was the main drug consumed by 60% of the subjects in the last month. Most of the subjects (82.4%) did not receive any substance abuse treatment and 4.2% of the subjects had taken opioid agonist treatment (methadone hydrochloride or buprenorphine hydrochloride) in the previous year.

The researchers concluded that participants that used opioid agonist therapy in the last 3 months had a lower frequency of HCV infection when compared with subjects that did not performed any treatment. Importantly, this study suggests that maintenance of opioid agonist therapy with methadone or buprenorphine for opioid addiction, such as heroin, may be an efficient and useful strategy to reduce HCV infection.

“Young injection drug users are a major driving force in the epidemic of HCV infection in the United States and Canada and therefore are an important target for prevention. … Our results suggest that treatment for opioid use disorders with maintenance opioid agonist therapy can reduce transmission of HCV in young adult injection drug users and should be offered as an important component of comprehensive strategies for prevention of primary HCV infection,” concluded the researcher team.

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