724A AASLD ABSTRACTS HEPATOLOGY, October, 2009
Maria Raptopoulou-Gigi, Emmanuel Sinakos, Albana Sykja, Eleni Gigi, Aristea-Lia Bellou, Ioannis Sidiropoulos, Eleni Orfanou; 2nd Medical Dpt, Aristotelion University Medical School, Thessaloniki, Greece
Intravenous drug users (IVDUs) are a group of patients with high prevalence of HBV and HCV infection. The aim of this study was to analyse epidemiological parameters, prevalence of HBV and HCV infection and treatment of hepatitis C in a large cohort of IVDUs followed- up between the years 1994-2008.
893 IVDUs were analysed retrospectively concerning demographic, laboratory and clinical parameters. All patients were evaluated in our outpatient clinic. All patients were abstinent of use; none was receiving substitution therapy and 75% were members of a detoxification program without substitution.
The mean age of patients was 30,3 years old (17-55). Most of them were men (84,3%), 95,6% were Greeks and 4,4% immigrants. 64,2% of patients reported alcohol abuse and 6% had psychiatric co-morbidity. Mean age of drug use institution was 19,5 years old (11-45). Mean duration of illicit drug use was 10,6 years and mean duration of intravenous use was 7,8 years. 65% of patients had tattoos. HBV infection was present in only 4,2% of patients (26,4% had high viremia) and 18,9% had evidence of past HBV infection. Among HBsAg negative patients only 18,3% had undergone partial or complete immunization against HBV. HCV infection was present in 642/893 patients (72%). 493/642 (76%) had positive HCV-RNA. Most of them were infected with genotype 3 (59,7%) (G1 24,7%, G2 4,6%, G4 11%). 271/493 (54,9%) of our patients with chronic hepatitis C received antiviral treatment (31% standard IFN monotherapy, 18% IFN plus ribavirin combination and 51% PEG-IFN plus ribavirin). Premature discontinuation, mainly due to relapse to drug abuse, was higher in the standard IFN groups (76% for monotherapy and 79% for combination therapy), whereas it was 46% for the pegylated IFN group. The overall SVR rates were 89% for genotype 3, 59% for 1, 44% for 4 and 100% for 2. CONCLUSIONS: Our data show a) the majority of IVDUs in Greece have chronic hepatitis C and genotype 3 is the prevalent genotype. b) although many of them discontinue treatment, those that complete therapy have SVR rates similar to patients without drug dependence and c) therapy for chronic hepatitis C should be also offered in IVDUs not receiving substitution therapy.
The following people have nothing to disclose: Maria Raptopoulou-Gigi, Emmanuel Sinakos, Albana Sykja, Eleni Gigi, Aristea-Lia Bellou, Ioannis Sidiropoulos, Eleni Orfanou