Psychoeducation improves hepatitis C virus treatment during opioid substitution therapy: a controlled, prospective multicenter trial
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Psychoeducation improves hepatitis C virus treatment during opioid substitution therapy: a controlled, prospective multicenter trial. / Reimer, Jens; Schmidt, Christiane Sybille; Schulte, Bernd; Gansefort, Dirk; Gölz, Jörg; Gerken, Guido; Scherbaum, Norbert; Verthein, Uwe; Backmund, Markus.
In: CLIN INFECT DIS, Vol. 57 Suppl 2, 01.08.2013, p. S97-104.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Psychoeducation improves hepatitis C virus treatment during opioid substitution therapy: a controlled, prospective multicenter trial
AU - Reimer, Jens
AU - Schmidt, Christiane Sybille
AU - Schulte, Bernd
AU - Gansefort, Dirk
AU - Gölz, Jörg
AU - Gerken, Guido
AU - Scherbaum, Norbert
AU - Verthein, Uwe
AU - Backmund, Markus
PY - 2013/8/1
Y1 - 2013/8/1
N2 - BACKGROUND: People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV) infection. However, PWID are considered "difficult to treat," requiring a specifically adapted treatment setting, including psychosocial support.METHODS: In this prospective, German trial, the impact of psychoeducation (PE) on retention and sustained virologic response (SVR) during HCV therapy among PWID was evaluated. We included 198 patients in opiate substitution therapy, who fulfilled indications for antiviral treatment. All patients received pegylated interferon alfa-2a and ribavirin therapy. Patients in the intervention group (n = 82) received manualized PE sessions.RESULTS: In patients with HCV genotype 1 or 4 (GT 1/4), PE was associated with increased treatment completion (76% vs 55%, P = .038), whereas PE had no such effect among GT 2/3 patients, who showed fewer dropouts and higher SVR rates. Among GT 1/4 patients, a minimum of 5 PE sessions was associated with increased SVR (71% vs 48%, P = .037). Multivariate regression analyses confirmed the impact of PE in GT 1/4 and revealed further predictors for retention and SVR, such as preexisting mental distress and adverse events.CONCLUSIONS: In patients with a higher risk of dropout due to GT 1/4 or mental distress, PE was shown to improve retention and SVR. PE is an effective supportive intervention for HCV therapy among PWID.
AB - BACKGROUND: People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV) infection. However, PWID are considered "difficult to treat," requiring a specifically adapted treatment setting, including psychosocial support.METHODS: In this prospective, German trial, the impact of psychoeducation (PE) on retention and sustained virologic response (SVR) during HCV therapy among PWID was evaluated. We included 198 patients in opiate substitution therapy, who fulfilled indications for antiviral treatment. All patients received pegylated interferon alfa-2a and ribavirin therapy. Patients in the intervention group (n = 82) received manualized PE sessions.RESULTS: In patients with HCV genotype 1 or 4 (GT 1/4), PE was associated with increased treatment completion (76% vs 55%, P = .038), whereas PE had no such effect among GT 2/3 patients, who showed fewer dropouts and higher SVR rates. Among GT 1/4 patients, a minimum of 5 PE sessions was associated with increased SVR (71% vs 48%, P = .037). Multivariate regression analyses confirmed the impact of PE in GT 1/4 and revealed further predictors for retention and SVR, such as preexisting mental distress and adverse events.CONCLUSIONS: In patients with a higher risk of dropout due to GT 1/4 or mental distress, PE was shown to improve retention and SVR. PE is an effective supportive intervention for HCV therapy among PWID.
KW - Adolescent
KW - Adult
KW - Aged
KW - Antiviral Agents
KW - Behavior Therapy
KW - Female
KW - Germany
KW - Hepatitis C
KW - Humans
KW - Interferon-alpha
KW - Male
KW - Medication Adherence
KW - Middle Aged
KW - Opiate Substitution Treatment
KW - Polyethylene Glycols
KW - Prospective Studies
KW - Recombinant Proteins
KW - Ribavirin
KW - Substance Abuse, Intravenous
KW - Treatment Outcome
KW - Viral Load
KW - Young Adult
U2 - 10.1093/cid/cit307
DO - 10.1093/cid/cit307
M3 - SCORING: Journal article
C2 - 23884073
VL - 57 Suppl 2
SP - S97-104
JO - CLIN INFECT DIS
JF - CLIN INFECT DIS
SN - 1058-4838
ER -