Hepatitis C Treatment Eligibility and Comorbid Medical Illness in Methadone Maintenance (MMT) and Non-MMT Patients: A Case-Control Study

ABSTRACT

Comorbid medical illness is common in patients with chronic hepatitis C (HCV) infection and in methadone treatment (MMT) patients, yet little is known about the impact of medical illness on HCV treatment eligibility. Medical illness and HCV treatment eligibility were compared in a case-control study of 80 MMT patients entering an HCV treatment trial and 80 matched non-MMT patients entering HCV treatment in a gastroenterology clinic. 91% of MMT and 85% of non-MMT patients had chronic medical conditions. Despite similar medical severity ratings, a significantly higher proportion (77%) of non-MMT patients were eligible for HCV treatment than were MMT patients (56%) (p < .01). Specific comorbid medical and psychiatric illness led to ineligibility in only 18% of MMT and 16% of non-MMT patients. However, failure to complete the medical evaluation process was significantly (p < .001) more likely to cause ineligibility among MMT patients (19%) than non-MMT patients (0%).

KEYWORDS:

• Hepatitis C
• treatment
• methadone
• opioid
• substance abuse
• comorbidity
• psychiatry

This work was supported by a grant from the National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) Grant No. R01 DA 016764.