Evaluation of a Multi-disciplinary Approach for the Treatment of Hepatitis C in IDUs (HI-LO Study)
Hepatitis C Virus Infection
About this trial
This is an interventional treatment trial for Hepatitis C Virus Infection focused on measuring HCV, injection drug users, ribavirin, pegylated interferon, illicit drug users
Eligibility Criteria
Inclusion Criteria:
- Age > 19 years;
- Serum HCV-RNA pos;
- HCV genotype 2 or 3;
- HBsAg neg;
- serum ALT > 1.5x upper limit normal > 3 months;
- Illicit drug use in the past year;
- Agreement from each participant of childbearing age to practice contraception;
- Absence of other contraindications to the initiation of therapy as determined by the health care team;
- Ability to provide informed consent.
Exclusion Criteria:
- Any cause for chronic liver disease other than HCV (including alcohol use >350 g/wk);
- Pregnant or breastfeeding women;
- Active HBV infection;
- Hemolytic anemia;
- Decompensated cirrhosis or portal hypertension or PT-INR > 1.3 or Child-Hugh class > A;
- Active suicidal ideation, psychosis, mania or hypomania;
- Serum creatinine > 180 µg/mL;
- Hemoglobin < 120 g/L in men or 110 g/L in women;
- Platelets < 90 x 109/L;
- Neutrophils < 1.5 x 109/L;
- Active autoimmune disease;
- NYHA disease > grade 2;
- Psoriasis requiring systemic therapy;
- Active malignancy apart from non melanoma skin cancer;
- Use of systemic immunosuppressant agents;
- Prior treatment of HCV with interferon or ribavirin;
- HIV positive with CD4 count <300 cells/mm3 or receiving didanosine (due to interaction with ribavirin);
- Life expectancy < 2 years.
Sites / Locations
- Pender Community Health Centre
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
1
2
The 4 participating sites are designated either High Intensity or Low Intensity. High Intensity sites have access to: full time specialist physicians, access to full time nurses and counselors. All weekly pegylated interferon injections will be administered by clinic staff and ribavirin will be dispensed in weekly medication pack.
The 4 participating sites are designated either High Intensity or Low Intensity. In the Low intensity group, all patients will have access to: full time primary care physicians, specialist physicians and access to part time nurse or counselor by appointment. Patients will be offered the option of self or nurse administered pegylated interferon injections on an appointment basis. Ribavirin will be dispensed biweekly. The treatment medication cannot be stored at the clinic; it must be the subjects responsibility.