Effective Treatment of Hepatitis C in Substance Users
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Purpose
We hypothesize that integrating Hepatitis C into methadone and buprenorphine treatment will improve Hepatitis C outcomes as well as drug treatment outcomes in patients who are addicted to opiates. We will test this hypothesis by randomly assigning patients to receive integrated or separated care. The first group will receive Hepatitis C treatment and substance abuse treatment contemporaneously at the South Central Rehabilitation Center (SCRC). They will take both methadone or buprenorphine and Hepatitis C medications under the daily (methadone) or weekly (buprenorphine) observation of a health care provider. The second group will receive substance abuse treatment at SCRC, and go to another facility to receive Hepatitis C treatment services. These participants will take their medications on their own (without observation).
We will look at outcomes such as Hepatitis C viral loads, adherence to medications, and drug treatment outcomes such as receipt of buprenorphine and methadone and urine toxicology testing.
| Condition | Intervention |
|---|---|
|
Hepatitis C Opiate Dependence |
Procedure: Modified Directly Observed Therapy (mDOT) Procedure: Self-Administered Therapy (SAT) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Effective Treatment of Hepatitis C in Substance Users |
- Number of Participants With a Sustained Virologic Response (SVR) [ Time Frame: 24 weeks (end of treatment) ] [ Designated as safety issue: No ]SVR is defined as continued undetectable HCV viral load at 24 weeks
| Enrollment: | 21 |
| Study Start Date: | April 2007 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Modified Directly Observed Therapy (mDOT)
Hepatitis C Virus (HCV) Treatment in Modified Directly Observed Therapy (mDOT) in Methadone Maintenance Treatment (MMT)
|
Procedure: Modified Directly Observed Therapy (mDOT) |
|
Active Comparator: Self-Administered Therapy at Liver Specialty Clinic (SAT)
Hepatitis C virus (HCV) at a liver specialty clinic as self-administered therapy
|
Procedure: Self-Administered Therapy (SAT) |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subjects with a DSM IV diagnosis of opioid dependence who are currently enrolled in methadone or buprenorphine maintenance at South Central Rehabilitation Center in good standing (opiate free urine with positive methadone or buprenorphine, respectively) for at least 30 days.
- Hepatitis C infection as evidenced by a positive HCV antibody and a detectable HCV RNA.
Exclusion Criteria:
- Suicidal or homicidal ideation
- Psychiatric condition that is not stable
- Pregnancy (RBV is a Class C drug during pregnancy)
- Pending court case or warrant which would interrupt treatment
- Decompensated cirrhosis (Child's Class B or C) or presence of hepatocellular carcinoma
- HIV+ with CD4<200 or CD4>200 and VL>5,000 copies/mL
- Platelet count < 75,000 /mL
- Hemoglobin < 10 mg/dL
- Absolute neutrophil count <1500 cells/mL
Contacts and Locations| United States, Connecticut | |
| South Central Rehabilitation Agency | |
| New Haven, Connecticut, United States, 06519 | |
| Principal Investigator: | R. Douglas Bruce, M.D. | Yale University |
More Information
No publications provided
| Responsible Party: | R. Douglas Bruce, MD, MA, Assistant Professor, Yale University |
| ClinicalTrials.gov Identifier: | NCT00633243 History of Changes |
| Other Study ID Numbers: | 0702002306, NIDA 022143 |
| Study First Received: | February 29, 2008 |
| Results First Received: | October 19, 2012 |
| Last Updated: | January 1, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Hepatitis Hepatitis A Hepatitis C Opioid-Related Disorders Liver Diseases Digestive System Diseases Hepatitis, Viral, Human |
Virus Diseases Enterovirus Infections Picornaviridae Infections RNA Virus Infections Flaviviridae Infections Substance-Related Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 22, 2013