Effects of buprenorphine and hepatitis C on liver enzymes in adolescents and young adults.
Effects of buprenorphine and hepatitis C on liver enzymes in adolescents and young adults.
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DOI：
10.1097/adm.0b013e3181c4e27e
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发表时间：
2010-12
影响因子：
5.5
通讯作者：
Woody GE
中科院分区：
文献类型：
--
作者：
Bogenschutz MP;Abbott PJ;Kushner R;Tonigan JS;Woody GE
本研究的目的是探索15-21岁阿片类药物依赖受试者中与丁丙诺啡治疗和丙型肝炎状态相关的转氨酶值的变化。152名寻求阿片类药物依赖治疗的受试者随机接受2周丁丙诺啡/纳洛酮（DETOX）或12周丁丙诺啡/纳洛酮（BUP）脱毒治疗。在基线和第4、8和12周时获得包括转氨酶在内的肝脏化学。111例患者在治疗期间至少有一组转氨酶，并被纳入治疗效果分析。总体而言，8/60名BUP参与者与12/51名DETOX参与者在随访期间至少有一个ALT值升高（卡方n.s.）。5/60名BUP参与者与11/51名DETOX参与者至少有一个AST值升高（卡方= 3.194，p = 0.048）。152名参与者中有28名在基线时为丙型肝炎（HCV）阳性，4名在12周内血清转换，每组2名。HCV状态与转氨酶异常显著相关（ALT和AST分别为p = 0.009和p = 0.006）。HCV状态对DETOX组受试者的转氨酶异常有很强的影响，但对BUP组受试者没有影响。在该探索性分析中，未发现丁丙诺啡肝毒性的证据。HCV存在于一个显着的少数参与者，是一个重要的预测转氨酶升高。结果表明，稳定丁丙诺啡可能会降低与丙型肝炎病毒在阿片类药物依赖的年轻人转氨酶异常的频率。高血清转化率突出了有效治疗和预防的重要性。
The purpose of this study was to explore changes in transaminase values associated with buprenorphine treatment and hepatitis C status among opioid dependent subjects aged 15–21. 152 subjects seeking treatment for opioid dependence were randomized to 2-week detoxification with buprenorphine/naloxone (DETOX) or 12 weeks buprenorphine/naloxone (BUP). Liver chemistries including transaminases were obtained baseline and at 4, 8, and 12 weeks. 111 patients had at least one set of transaminases during treatment and were included in analyses of treatment effects. Overall, 8/60 BUP participants vs. 12/51 DETOX participants had at least one elevated ALT value during follow-up (Chi-square n.s.). 5/60 BUP participants vs. 11/51 DETOX participants had at least one elevated AST value (Chi-square = 3.194, p = .048). Twenty-eight out of 152 participants were hepatitis C (HCV) positive at baseline, and 4 seroconverted within 12 weeks, 2 in each group. HCV status was significantly associated with transaminase abnormalities (p = .009 and p = .006 for ALT an AST, respectively). HCV status had a strong effect on transaminase abnormalities among participants assigned to DETOX, but not among those assigned to BUP. No evidence was found for hepatotoxicity of buprenorphine in this exploratory analysis. HCV was present in a significant minority of participants and was a significant predictor of transaminase elevation. Results suggest that stabilization on buprenorphine may decrease the frequency of transaminase abnormalities associated with HCV in opioid dependent young people. The high rate of seroconversion underscores the importance of effective treatment and prevention.