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Hepatitis C virus infection influences the S-methadone metabolite plasma concentration
- Source :
- PLoS ONE, Vol 8, Iss 7, p e69310 (2013), PLoS ONE
- Publication Year :
- 2013
- Publisher :
- Public Library of Science (PLoS), 2013.
-
Abstract
- Background and Objectives Heroin-dependent patients typically contract hepatitis C virus (HCV) at a disproportionately high level due to needle exchange. The liver is the primary target organ of HCV infection and also the main organ responsible for drug metabolism. Methadone maintenance treatment (MMT) is a major treatment regimen for opioid dependence. HCV infection may affect methadone metabolism but this has rarely been studied. In our current study, we aimed to test the hypothesis that HCV may influence the methadone dosage and its plasma metabolite concentrations in a MMT cohort from Taiwan. Methods A total of 366 MMT patients were recruited. The levels of plasma hepatitis B virus (HBV), HCV, human immunodeficiency virus (HIV) antibodies (Ab), liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) were measured along with the urine morphine concentration and amphetamine screening. Results Of the 352 subjects in our cohort with HCV test records, 95% were found to be positive for plasma anti-HCV antibody. The liver functional parameters of AST (Wilcoxon Rank-Sum test, P = 0.02) and ALT (Wilcoxon Rank-Sum test, P = 0.04), the plasma methadone concentrations (Wilcoxon Rank-Sum test, P = 0.043) and the R-enantiomer of methadone concentrations (Wilcoxon Rank-Sum test, P = 0.032) were significantly higher in the HCV antibody-positive subjects than in the HCV antibody-negative patients, but not the S-EDDP/methadone dose ratio. The HCV levels correlated with the methadone dose ( = 14.65 and 14.13; P = 0.029 and 0.03) and the S-EDDP/methadone dose ratio ( = −0.41 and −0.40; P = 0.00084 and 0.002) in both univariate and multivariate regression analyses. Conclusions We conclude that HCV may influence the methadone dose and plasma S-EDDP/methadone dose ratio in MMT patients in this preliminary study.
- Subjects :
- Male
Pyrrolidines
Epidemiology
Gastroenterology and hepatology
Hepacivirus
lcsh:Medicine
Pharmacology
medicine.disease_cause
Drug Metabolism
lcsh:Science
Cell Line, Transformed
Psychiatry
Multidisciplinary
biology
Substance Abuse
virus diseases
Hepatitis C
Infectious hepatitis
Mental Health
Medicine
Regression Analysis
Female
Aryl Hydrocarbon Hydroxylases
medicine.drug
Research Article
Adult
Methadone maintenance
Drugs and Devices
Hepatitis C virus
medicine
Humans
Pharmacokinetics
Liver diseases
Demography
Hepatitis B virus
Dose-Response Relationship, Drug
business.industry
Pharmacoepidemiology
lcsh:R
Hepatitis C Antibodies
medicine.disease
biology.organism_classification
digestive system diseases
Cytochrome P-450 CYP2B6
Opioid
Multivariate Analysis
Morphine
lcsh:Q
business
Methadone
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 8
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....588484e307b0a81e7c5772ec68e5428c