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https://www.readbyqxmd.com/read/28404135/incidence-risk-factors-and-prevention-of-hepatitis-c-reinfection-a-population-based-cohort-study
#1
Nazrul Islam, Mel Krajden, Jean Shoveller, Paul Gustafson, Mark Gilbert, Jane A Buxton, Jason Wong, Mark W Tyndall, Naveed Zafar Janjua
BACKGROUND: People remain at risk of reinfection with hepatitis C virus (HCV), even after clearance of the primary infection. We identified factors associated with HCV reinfection risk in a large population-based cohort study in British Columbia, Canada, and examined the association of opioid substitution therapy and mental health counselling with reinfection. METHODS: We obtained data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for HCV or HIV at the British Columbia Centre for Disease Control Public Health Laboratory during 1990-2013 (when data were available)...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28397700/narcotic-bowel-syndrome
#2
REVIEW
Adam D Farmer, Jayne Gallagher, Caroline Bruckner-Holt, Qasim Aziz
Narcotic bowel syndrome is characterised by worsening abdominal pain in the context of escalating or continuous opioid therapy. Although narcotic bowel syndrome is rarely diagnosed, given the current epidemic of opioid use, it is likely to be under-recognised. The underlying pathophysiological mechanisms of narcotic bowel syndrome are incompletely understood; however, opioid-induced hyperalgesia is likely to be a central facet. The putative mechanisms of hyperalgesia include activation of bimodal opioid regulatory systems, counter-regulatory mechanisms, neuroinflammation, opioid facilitation, and interactions of the N-methyl D-aspartate receptor with opioids at the level of the spinal cord...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28376505/six-year-outcome-of-opioid-maintenance-treatment-in-heroin-dependent-patients-results-from-a-naturalistic-study-in-a-nationally-representative-sample
#3
Michael Soyka, Jens Strehle, Jürgen Rehm, Gerhard Bühringer, Hans-Ulrich Wittchen
BACKGROUND: In many countries, the opioid agonists, buprenorphine and methadone, are licensed for maintenance treatment of opioid dependence. Many short-term studies have been performed, but little is known about long-term effects. Therefore, this study described over 6 years (1) mortality, retention and abstinence rates and (2) changes in concomitant drug use and somatic and mental health. METHODS: A prevalence sample of n = 2,694 maintenance patients, recruited from a nationally representative sample of n = 223 substitution doctors, was evaluated in a 6-year prospective-longitudinal naturalistic study...
April 5, 2017: European Addiction Research
https://www.readbyqxmd.com/read/28345206/treatment-with-direct-acting-antiviral-agents-of-hepatitis-c-virus-infection-in-injecting-drug-users-a-prospective-study
#4
Lucio Boglione, Simone Mornese Pinna, Amedeo De Nicolò, Jessica Cusato, Giuseppe Cariti, Giovanni Di Perri, Antonio D'Avolio
In this prospective study, we evaluated the effectiveness and tolerability of novel therapies against hepatitis C virus (HCV) in a cohort of PWID enrolled at our centre from April 2015 to July 2016. In this analysis, a total of 174 patients were included: 11 (6.3%) were treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) containing regimens, 163 (93.7%) with IFN-free treatments. RBV has been used in 70 patients (40.2%); 59 (33.9%) patients were in opioid substitution therapy (OST) with methadone or buprenorphine...
March 26, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28323752/impact-of-opioid-substitution-therapy-on-the-hiv-prevention-benefit-of-antiretroviral-therapy-for-people-who-inject-drugs
#5
Christinah Mukandavire, Andrea Low, Gitau Mburu, Adam Trickey, Margaret T May, Charlotte F Davies, Clare E French, Katharine J Looker, Tim Rhodes, Lucy Platt, Andy Guise, Matthew Hickman, Peter Vickerman
OBJECTIVE: A recent meta-analysis suggested that opioid substitution therapy (OST) increased uptake of anti-retroviral treatment (ART) and HIV viral suppression. We modelled whether OST could improve the HIV prevention benefit achieved by ART amongst people who inject drugs (PWID). METHODS: We modelled how introducing OST could improve the coverage of ART across a PWID population for different baseline ART coverage levels. Using existing data on how yearly HIV-transmission risk is related to HIV plasma viral load, changes in the level of viral suppression across the population were used to project the relative reduction in yearly HIV-transmission risk achieved by ART, with or without OST, compared to if there was no ART - defined here as the prevention effectiveness of ART...
March 18, 2017: AIDS
https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#6
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28303199/hiv-aids-in-the-south-east-asia-region-progress-and-challenges
#7
EDITORIAL
Razia Pendse, Somya Gupta, Dongbao Yu, Swarup Sarkar
The South-East Asia region, with 11 member states, has an estimated 3.5 million people living with HIV (PLHIV). More than 99% of PLHIV live in five countries where HIV prevalence among the population aged 15-49 remains low but is between 2% and 29% among key populations. Since 2010, the region has made progress to combat the epidemic. Mature condom programmes exist in most countries but opioid substitution therapy, and needle and syringe exchange programmes need to be scaled up. HIV testing is recommended nationwide in four countries and is prioritised in high prevalence areas or for key populations in the rest...
November 28, 2016: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28281354/integrated-opioid-substitution-therapy-and-hiv-care-a-qualitative-systematic-review-and-synthesis-of-client-and-provider-experiences
#8
Andy Guise, Maureen Seguin, Gitau Mburu, Susie McLean, Pippa Grenfell, Zahed Islam, Sergii Filippovych, Happy Assan, Andrea Low, Peter Vickerman, Tim Rhodes
People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts...
March 10, 2017: AIDS Care
https://www.readbyqxmd.com/read/28258833/changes-in-substance-use-in-patients-receiving-opioid-substitution-therapy-and-resulting-clinical-challenges-a-17-year-treatment-case-register-analysis
#9
Marcus Herdener, Kenneth M Dürsteler, Erich Seifritz, Carlos Nordt
BACKGROUND: Although the beneficial effects of opioid substitution for the reduction of heroin use are well established, its effect on other substance use is unclear. We aimed to evaluate short-term and long-term changes in substance use in opioid-dependent patients on opioid substitution therapy. We focused on frequent use of heroin, cocaine, benzodiazepines, and alcohol under naturalistic conditions (ie, with non-selected patients and clinical practice as usual) over 17 years. METHODS: This was a treatment case register analysis...
February 28, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28258832/alcohol-problems-need-more-attention-in-patients-receiving-long-term-opioid-substitution-therapy
#10
Wayne D Hall, John Strang
No abstract text is available yet for this article.
February 28, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28209683/evaluation-of-6-remote-first-nations-community-based-buprenorphine-programs-in-northwestern-ontario-retrospective-study
#11
Solomon Mamakwa, Meldon Kahan, Dinah Kanate, Mike Kirlew, David Folk, Sharon Cirone, Sara Rea, Pierre Parsons, Craig Edwards, Janet Gordon, Fiona Main, Len Kelly
OBJECTIVE: To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. DESIGN: Retrospective cohort study. SETTING: Six First Nations communities in northwestern Ontario. PARTICIPANTS: A total of 526 First Nations participants in opioid-dependence treatment programs...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#12
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison healthcare, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; 7 female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28130810/shift-in-disparities-in-hepatitis-c-treatment-from-interferon-to-daa-era-a-population-based-cohort-study
#13
N Z Janjua, N Islam, J Wong, E M Yoshida, A Ramji, H Samji, Z A Butt, M Chong, D Cook, M Alvarez, M Darvishian, M Tyndall, M Krajden
We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015...
January 27, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28070918/stereotype-threat-and-social-function-in-opioid-substitution-therapy-patients
#14
Courtney von Hippel, Julie D Henry, Gill Terrett, Kimberly Mercuri, Karen McAlear, Peter G Rendell
OBJECTIVES: People with a history of substance abuse are subject to widespread stigmatization. It seems likely that this societal disapproval will result in feelings of stereotype threat, or the belief that one is the target of demeaning stereotypes. If so, stereotype threat has the potential to contribute to functional difficulties including poor social outcomes. METHODS: Eighty drug users on opioid substitution therapy and 84 demographically matched controls completed measures of mental health and social function...
January 10, 2017: British Journal of Clinical Psychology
https://www.readbyqxmd.com/read/27958381/a-polymorphism-in-the-oprm1-3-untranslated-region-is-associated-with-methadone-efficacy-in-treating-opioid-dependence
#15
R C Crist, G A Doyle, E C Nelson, L Degenhardt, N G Martin, G W Montgomery, A J Saxon, W Ling, W H Berrettini
The μ-opioid receptor (MOR) is the primary target of methadone and buprenorphine. The primary neuronal transcript of the OPRM1 gene, MOR-1, contains a ~13 kb 3' untranslated region with five common haplotypes in European-Americans. We analyzed the effects of these haplotypes on the percentage of opioid positive urine tests in European-Americans (n=582) during a 24-week, randomized, open-label trial of methadone or buprenorphine/naloxone (Suboxone) for the treatment of opioid dependence. A single haplotype, tagged by rs10485058, was significantly associated with patient urinalysis data in the methadone treatment group...
December 13, 2016: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/27935442/psychosis-after-switch-in-opioid-maintenance-agonist-and-risperidone-induced-pisa-syndrome-two-critical-incidents-in-dual-diagnosis-treatment
#16
Manuel Sutter, Marc Walter, Kenneth M Dürsteler, Johannes Strasser, Marc Vogel
BACKGROUND AND AIMS: Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION: We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation...
December 9, 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27931232/retention-in-georgia-opioid-substitution-therapy-program-and-associated-factors
#17
Ekaterine Ruadze, Khatuna Todadze
BACKGROUND: Substance abuse has been considered as a growing challenge in Georgia that is closely linked with human immune deficiency virus (HIV) and hepatitis C transmission due to unsafe injection and other uncontrolled behaviors. Methadone maintenance therapy is one of the major treatment options for opioid-dependent individuals. It has proven efficacy in decreasing illegal opioid consumption and criminal behavior as well as reducing the level of HIV infection, mortality, HCV infection, and increasing social functioning...
December 8, 2016: Harm Reduction Journal
https://www.readbyqxmd.com/read/27927256/the-effects-of-needle-sharing-and-opioid-substitution-therapy-on-incidence-of-hepatitis-c-virus-infection-and-reinfection-in-people-who-inject-drugs
#18
C K Aitken, P A Agius, P G Higgs, M A Stoové, D S Bowden, P M Dietze
Although high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs' use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7·6 [95% confidence interval (CI) 4·8-11·9], 12·4 (95% CI 9·1-17·0) and 9·7 (95% CI 7·4-12·6) per 100 person-years, respectively...
December 8, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27923769/recombination-in-hepatitis-c-virus-is-not-uncommon-among-people-who-inject-drugs-in-kolkata-india
#19
Debanjali Gupta, Kallol Saha, Aritra Biswas, Rushna Firdaus, Monika Ghosh, Provash Chandra Sadhukhan
Recombination in RNA virus is a rare event in the survival and evolution to evade host immune system. This is increasing within high risk group population (HRG) due to super infection that occurs by continuous sharing of common drug equipment by HCV infected or HIV-HCV co-infected recurrent drug users. Recombination causes impediment to vaccine development and therapeutic intervention as standard HCV treatment is still genotype specific. Blood samples of 194 people who inject drugs (PWID) were collected from an Opioid Substitution Therapy Centre in Kolkata, India...
December 5, 2016: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/27898497/medications-for-addiction-treatment-changing-language-to-improve-care
#20
Sarah E Wakeman
The term medication-assisted treatment has been widely adopted in reference to the use of opioid agonist therapy. Although it is arguably better than the older terms of replacement or substitution therapy, medication-assisted treatment implies that medications are a corollary to whatever the main part of treatment is. No other medication for other health conditions is referred to this way. It has finally been recognized that to improve care and reduce stigma, we must use medically accurate and person-first language, describing those with the disease of addiction as people with substance use disorder...
January 2017: Journal of Addiction Medicine
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