Problems in Inducing Interferon Therapy of Opiate Addicts with Chronic Hepatitis C Who Are In Substitution Maintenance Therapy with Buprenorphine/Naloxone (Suboxone®)

Chronic hepatitis C virus (HCV) is highly infected disease with long period of failure to recognize it, what leads to chronic liver damage and lower chances for complete cure if detected late. Intravenous opiate users (IDU) often pass the infection to other IDUs, or themselves be infected from virus carriers using the same non-sterile equipment. After the implementation of substitution treatment of opiate addicts (OST) with July 2009 year, serological tests for chronic hepatitis B and C and HIV were indispensable, as well as laboratory findings with liver function parameter analysis as a condition for starting OST. In this way we discovered 50 chronic hepatitis C positive opiate addicts out of 195 of those whom we induced in OST. Although faced with danger of the final result if not treated in time, addicts when become aware that they were chronic hepatitis C positive, they avoid further needed procedures leading to the inclusion of specific therapy with Peginterferon plus Ribavirin. The authors present the problems that chronic hepatitis C positive opiate addicts bring out as a reason they do not accept the continuation of the procedure detecting HCV genotypes, and the inclusion of specific therapy for the chronic hepatitis C treatment in the Departments for Infectious or Internal diseases. The authors present efforts of experts responsible for the chronic hepatitis C treatment to organize a multidisciplinary team, in order to coordinate Interferon therapy for each chronic hepatitis C positive IDUs.