Suboxone & Methadone Response and SVR

[nygirl7]

This won't apply to many people on here but it's been asked a lot and hopefully someone looking can find this study.

IV Drugs Users on Opioid Substitution Respond to Antiviral Treatment for HCV: Presented at DDW
By Charlene Laino

NEW ORLEANS -- May 11, 2010 -- Intravenous (IV) drug users who are on opioid substitution and infected with hepatitis C virus (HCV) can be successfully treated with antiviral therapy, researchers reported here at Digestive Disease Week (DDW) 2010.

Olga Anagnostou, MD, Greek Organization Against Drugs (OKANA), Athens, Greece, presented the findings here on May 3.

Intravenous drug use is a main cause of HCV transmission in Western countries, but such patients are sometimes excluded from antiviral treatment because of concerns regarding low adherence and response rates in treatment, she said.

Dr. Anagnostou and colleagues evaluate HCV treatment outcomes among IV drug users receiving opioid substitution treatment with methadone or buprenorphine at 4 government-funded clinics between 2002 and 2008.

The analysis involved 93 IV drug users with HCV infection who started combination treatment with pegylated interferon alfa-2a or -2b and ribavirin while on methadone or buprenorphine.

Forty-six (48.4%) patients were on methadone, and 49 (51.6%) were on buprenorphine.

Of the total, 77 (82.8%) patients completed their antiviral treatment schedule, 7 (7.5%) discontinued treatment due to side effects, and 9 (9.7%) dropped out due to their own reasons.

At 6 months, 66.7% of patients had sustained virologic responses.

Substitution treatment with buprenorphine was associated with both higher adherence rates (27.3% vs 8.1%, P = .04) and higher sustained viral response rates (83.3% vs 48.9%, P = .002), compared with methadone use.

In multivariate analyses, adherence to treatment (P < .0001) and buprenorphine use (P = .007) were independently associated with a greater chance of sustained virologic response.

Buprenorphine may be a more effective treatment for opioid withdrawal, Dr. Anagnostou said during a press briefing.

The bottom line, she said, is that intravenous drug users should not be excluded from antiviral treatment. "They can get treated as long as they adhere, and they do adhere when they are treated in a setting such as this one," she said.

Digestive Disease Week 2010 is cosponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).

[ZaNTuS]

I do agree that buprenorphine (Suboxone/Subutex) is a much better, safer choice for us hcv carriers as it's only a partial opioid agonist.  Full agonists such as morphine, oxycodone, herion, & methadone cause certain immune functions to hibernate but heightens other immune functions (i.e. Reason for replication due to virus being threatened).  I speak from experience an not just from the few clinical trials that have been done.  I can tell when the dragon is pissed or not because morphine & oxycodone are what triggered my God-like symptoms (Symptoms that i have read that happen when on tx) an eventually led to my diagnosis.  For years (8) i abused Norco taking ridiculous amounts everyday then my "Buzz" started getting weaker an weaker then i kicked em an was completely clean for almost 2 years exercising 2 hours a day 5-6 days a week.  I fought through the fatigue, heartburn, tinnitus, blurry vision/floaters thinking it was just my brain re-adjusting after the 8+ years of Norco abuse.  Then the stabbing pains/liver inflammation started...doctor after doctor said the only thing it could be was gallbladder trouble.  I'm just over 3 weeks post-op an can't believe i had it out for no reason...They gave me morphine after the surgery an it caused massive replication for 4 days afterwards!  It has been a TRUE REAL nightmare the past few years but am glad i finally figured this beast out.  I left out the part i relapsed WITH Suboxone but note that it DID cause mild replication when i 1st started it but the stabbing pain eventually went away once my body and/or the virus adjusted.  My 2 cents.

[becksta29]

thanx for that info,i know ppl who have cleared it on methadone,n my brother is on methadone n wants to treat with the new drugs when they come out,he is geno type 1 n he was worried bout being on the methadone whilst treating.