Background/Aim. Hepatitic C infection (HCV) is a systemic, generalised
disease with the prevalence of inflammation in the liver. The aim of this
study was to determine the success of treatment for chronic hepatitis C with
pegilated interferon alfa 2a and ribavirin in injecting drug users. Methods.
This a 5-year follow-up study included 30 patients [63.3% men and 36.7%
women, average age 30.2 years (SD 7.1 years)] injecting drug users in
one-year abstinence, with chronic hepatitis C, treated with the pegilated
interferon ? 2a and ribavirin. Complete history with possible route of
infection, the standard biochemical tests, liver biopsy, quantification of
the viral genome in sera and HCV genotyping and subtyping were done prior to
the therapy initiation. Depending on the HCV genotype, the therapy was
conducted over a period of 48 weeks for genotype 1 and 24 weeks for genotype
non 1. Five years later all 30 patients were invited on control examination;
22 of them appeared at the check-up and quantification of the viral genome in
their sera were analized. Results. The established degree of liver fibrosis
was: F0 in 40%, F1 in 23.33%, F2 in 26.67%, F3 in 3.33% and F4 in 6.67% of
the patients. Genotype 3a was dominant (50.0%), 1b was registered in 40.0%,
1a in 6.66% and 2b in 3.33% of the patients. Sustained virologic response
(SVR) was achieved in 86.7% of the patients, 10.0% of the patients were
non-responders, while 3.33% of them revealed recurrence of HCV. Opiate abuse
recurrence during antiviral therapy happened in 6.7% of the patients. Five
years after the antiviral therapy 73.3% of the patients appeared at the
check-up and all of them were in stable abstinence from opiate abuse. All of
those, with a sustained viral response of five-year duration, had the
negative PCR HCV RNA test (< 50 IU ml-1). In the patients showing
unsatisfactory therapy response 5 years before, antiviral therapy was
repeated by the same therapeutic regimen, but without adequate therapeutic
response. A total of 26.7% of the patients were lost from the records.
Conclusion. In a 5-year follow-up period 73.3% of the patients used to come
regularly to check-ups and among them neither the opiate abuse recurrence nor
HCV infection recurrence were registered.
Injecting drug users with chronic hepatitis C: should they be offered antiviral therapy?
