Research Report Eur Addict Res 2000;6:198–204 Prevalence and Distribution of Hepatitis C Subtypes in Patients with Opioid Dependence Wolfgang Gombas a Gabriele Fischer a Reinhold Jagsch a Harald Eder a Ichiro Okamoto a Shird Schindler a Christian Müller b Peter Ferenci b Siegfried Kasper a a Drug Addiction Out-Patient Clinic, Department of General Psychiatry, University Hospital for Psychiatry, and b Clinical Department of Gastro-Enterology and Hepatology, University Hospital for Internal Medicine, IV, Vienna, Austria Dr. Wolfgang Gombas Währinger Gürtel 18–20 A–1090 Vienna (Austria) Tel. +43 1 40400 3552, Fax +43 1 409 19 13 E-Mail a8700306@unet.univie.ac.at ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2000 S. Karger AG, Basel 1022–6877/00/0064–0198$17.50/0 Accessible online at: www.karger.com/journals/ear Key Words Hepatitis C W Drug addiction W Human immunodeficiency virus W Hepatitis B Abstract Aim and Setting: The drug addiction out-patient clinic at the University Hospital for Psychiatry in Vienna per- formed a study to identify the prevalence of hepatitis C virus (HCV) infections in a group of opiate-dependent patients, to detect the distribution of HCV subtypes and to calculate the comorbidity of human immunodeficien- cy virus (HIV) and hepatitis B virus (HBV). Design and Participants: We consecutively investigated unselected patients (n = 173) during an observation period of 2 months with the diagnosis of opioid dependence (DSM- IV: 304.0) and polysubstance dependence (DSM-IV: 304.9). Measurements: Blood was investigated focusing on liver enzymes and on viral status including HIV, hepa- titis B and hepatitis C, followed by subtyping of the virus. Findings: In 80.3% hepatitis C antibodies were found, 66.5% were HCV RNA (PCR) positive. 3a was the most frequent subtype (35.6%), followed by 1a (28.8%) and 1b (22.0%). Four patients had both subtypes 1a and 1b (6.8%), 3 were 2b positive (5.1%) and 1 patient had sub- types 2a/2c (1.7%). No significant difference in aspartate (AST) and alanine aminotransferases (ALT) concerning the different subtypes (AST: p = 0.290; ALT: p = 0.260) could be calculated; 11.6% showed co-infection with HIV, 2 patients had a chronic infection with hepatitis B. Con- clusions: The rate of HCV infection in substance-depen- dent patients at our drug addiction out-patient clinic is extremely high. The distribution of subtypes showed a relatively homogeneous distribution of the types 1a, 1b and 3a. The recommended therapy with ·-interferon should be initiated in drug-dependent patients under considerations of an enrollment in oral maintenance with synthetic opioids. Copyright © 2000 S. Karger AG, Basel Introduction The hepatitis C virus (HCV) was first described as an independent virus in 1989 by Choo et al. [1] and later by Tillmann and Michael [2] and Akahane et al. [3]. At Downloaded by: Medical University Vienna - University Library 149.148.41.25 - 2/2/2015 11:11:20 AM