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Hepatitis C Screening and Treatment Outcomes in Patients With Substance Use/Dependence Disorders

Received August 23, 2004; revised February 25, 2005; accepted April 6, 2005. From the University of Virginia, School of Medicine, Roanoke-Salem, Salem, VA; and the Veterans Affairs Medical Center, Salem, VA. Address correspondence and reprint requests to Dr. Rifai, Northwest Hepatitis C Research Center, Portland VA Medical Center and Oregon Health and Science Univ., P.O. Box 1034, P3MHADM, Portland, OR 97239. e-mail: AlyRifai{at}aol.com

The authors evaluated the association between hepatitis C virus (HCV) seropositivity status and substance use treatment outcomes in an alcohol- and substance-dependent population undergoing rehabilitation. The second aim was to assess the impact of early screening for HCV infection and substance use treatment on HCV treatment outcomes. HCV-antibody testing of 338 patients attending a substance-use residential program was performed. HCV antibody status, lifetime comorbid psychiatric diagnoses, program completion rates, and 6-month abstinence rates after program discharge were assessed. HCV treatment outcomes were followed in patients who remained abstinent 6 months after completion of substance-use treatment. Almost one-fourth (23.1%) of patients were HCV antibody-positive. HCV-seropositive patients were more likely to complete the 28-day program and more likely to remain abstinent at 6 months after program discharge. HCV seropositive status was the strongest predictor for the likelihood of completing the program, and remaining abstinent for 6 months afterward. Patients with HCV who completed a substance-use treatment program were more likely to receive HCV treatment than substance-dependent patients with HCV who never attended a substance-use treatment program. Detecting HCV infection in the structured setting of substance-use treatment is ideal to initiate management of this infection, and it has a positive influence on the outcomes of both substance-use treatment and HCV treatment.

Key Words: Hepatitis C • Substance Use • Substance Dependence • Psychiatric Disorders • Interferon

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