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document
Similar compliance and effect of treatment in chronic hepatitis C resulting from intravenous drug use in comparison with other infection causes . OBJECTIVES There is some reluctance to treat intravenous drug users ( IVDUs ) with chronic hepatitis C ( CHC ) because of presumed lower compliance and response to antiviral therapy . We intended to evaluate the compliance and response to antiviral treatment for CHC in IVDUs compared with non-IVDUs . METHODS A retrospective cohort study -- secondary analysis of the results of a treatment trial -- was performed in Belgium and The Netherlands . A total of 406 previously untreated CHC patients , including 98 ( 24 % ) IVDUs , were studied for compliance ( presentation at the end of treatment ) , complete response ( alanine aminotransferase within normal limits and serum hepatitis C virus polymerase chain reaction negative ) at the end of therapy and sustained virological response ( SVR ) . RESULTS Non-compliance ( 8.2 % ) in IVDUs was not different from non-IVDUs ( 6.8 % ) ( relative risk=1.20 ; 95 % confidence interval=0.55-2.62 ) . Complete response after controlling for hepatitis C virus was similar ( relative risk=1.19 ; 95 % confidence interval=0.89-1.60 ) . Controlling for treatment arm , age , sex , presence of cirrhosis or hepatitis C virus viral load before treatment did not change these results . There was a marginally significant difference in the sustained virological response between IVDUs ( 46.6 % ) and non-IVDUs ( 34.6 % ) ( relative risk=1.35 ; 95 % confidence interval=1.00-1.81 ) , also disappearing after adjusting for genotype . No difference in compliance or sustained virological response was found between active and non-active IVDUs or between IVDU patients in or without a methadone maintenance program . CONCLUSIONS In this group of Benelux patients , IVDUs showed similar compliance and response to treatment with interferon and ribavirin compared with other patients with CHC infection . Therefore , it is no longer justifiable to withhold treatment to chronic hepatitis C patients who use intravenous drugs .
25091
Intervention_Pharmacological
intravenous drug use
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Intervention_Pharmacological
antiviral therapy
25093
Intervention_Pharmacological
antiviral treatment for CHC
25094
Outcome_Mental
Non-compliance
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Outcome_Physical
Complete response
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Outcome_Physical
sustained virological response
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Outcome_Physical
compliance or sustained virological response
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Outcome_Mental
similar compliance
25099
Outcome_Physical
response
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Outcome_Physical
chronic hepatitis C