Predictors of adherence to treatment of chronic hepatitis C in drug-dependent Inmate Patients in four prisons in Barcelona, Spain

Abstract

Background: Drug addiction is not a contraindication to indicate treatment of chronic hepatitis C (CHC), but it has been observed that consumers are more abandon. To study the clinical outcome of hepatitis C treatment in inmate patients with a history in injecting drugs and to analyze which were the causes of abandon. Methods: Amulticenter retrospective clinical trial including 162 inmate patients that underwent HCV therapy with pegylated interpheron and ribavirin between January 2003 and January 2008 was performed. It was found in medical history who completed treatment. We used a questionnaire to determine variables associated with discontinuation of treatment and multivariate analysis was performed using logistic regression to identify predictors. Results: 82,7% were intravenous drug users, 21.7% had HIV coinfection and 20,5% were on methadone maintenance therapy. 91,4% completed the whole treatment; 33.1% admitted heroin and/or cocaine consumption during therapy and 7.9% admitted needle and syringe-sharing. Relapse in intravenous consumption in or out of prison was the only one predictive factor of treatment interruption (OR: 10.39, IC: 1.93-55.88; p= 0.006). Conclusion: Only 9,6% of patients discontinued treatment. Drug use was the main cause of discontinuation of treatment. We recommend the treatment of drug addiction to reduce the discontinuations of treatment for chronic hepatitis C.