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Characteristics and Impact of Methamphetamine Use in Patients With Chronic Hepatitis C

Riley, Dana E. BA; Liu, Lin PhD; Cohen, Benjamin MD; Robinson, Shannon MD; Groessl, Erik J. PhD; Ho, Samuel B. MD

doi: 10.1097/ADM.0000000000000001
Original Research

Objectives: Methamphetamine (MA) use has increased in the United States in the last 20 years and is a risk factor for hepatitis C virus(HCV) infection. The purpose of this study was to determine the characteristics and HCV infection outcomes of patients with a history of MA use.

Methods: Subjects consisted of newly entered patients in the Veterans Affairs (VA) HCV registry at a single VA medical center from January 1, 2004, to June 30, 2004, and from January 1, 2007, to June 30, 2007. Univariate and multivariate analyses related to HCV infection antiviral treatment outcomes through 2010 was performed.

Results: A total of 198 consecutive eligible HCV registry patients were analyzed, and 40% had a history of MA use. Of patients with MA use history, 46% (36/79) had active use (within 6 months) at initial contact. Active MA users were significantly younger (mean age, 45.5 years), with more concomitant drug use (86%), compared with patients without MA use (mean age, 53.5 years; 42% minority; 29% other drug use). Overall, 71% of the 198 patients reported a history of problematic alcohol use, and 47% of those reported active abuse. Logistic regression analyses indicated that MA use did not significantly adversely affect antiviral treatment initiation, completion, or sustained virological response rates compared with that in patients without MA use. Active alcohol users had lower treatment initiation than patients without alcohol use.

Conclusions: MA use is common in recent US veterans with HCV infection and occurs in younger patients with polysubstance use. Prior history or active MA use does not seem to adversely affect HCV infection clinic treatment compared with that in HCV-infected patients without MA use.

From the Departments of Medicine (DER, BC, SBH), Health Services Research and Development (LL, EJG), and Psychiatry (SR), VA San Diego Healthcare System, San Diego, CA; and Departments of Family and Preventive Medicine (LL, EJG), Medicine (BC, SBH), and Psychiatry (SR), University of California, San Diego.

Send correspondence and reprint requests to Samuel B. Ho, MD, VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161. E-mail: samuel.ho2@va.gov.

Supported by Veterans Affairs Health Service Research and Development grant IIR 07-101-3, the VA Quality Enhancement Research Initiative, and the Research Service of the Department of Veterans Affairs. Samuel B. Ho, MD, received research and grant support from Genetech, Inc, Vital Therapies, Inc, and Aspire Bariatrics, Inc. Expert panel fees were paid by Roche Pharmaceuticals, Inc.

The authors report no conflicts of interest.

Received January 03, 2013

Accepted September 11, 2013

© 2014 American Society of Addiction Medicine