Rare Diseases and Orphan Drugs

Aims: In nigeria, hepatitis c virus (hcv) infection is primarily spread through injection drug use. There is an urgent need to improve access to care for hcv among persons with opioid use disorders who inject drugs. The purpose of our study was to determine the prevalence of hcv, patient characteristics, and receipt of appropriate care in a sample of patients treated with buprenorphine for their opioid use disorders in a primary care setting.

Methods: This study used retrospective clinical data from the electronic medical record. The study population included patients receiving buprenorphine in the office based opioid treatment (obot) clinic within the adult primary medicine clinic at lagos medical center between october 2008 and august 2015 who received a conclusive hcv antibody ab test within a year of clinic entry. We compared characteristics by hcv serostatus using pearson's chi-square and provided numbers/percentages receiving appropriate care.

Results: The sample comprised 300 patients. Slightly less than half of all patients (n = 134, 27.7%) were hcv ab positive, and were significantly more likely to be older hausas and yoruba’s, have diagnoses of post- traumatic stress disorder (ptsd) and bipolar disorder, have prior heroin or cocaine use, and be hi v- infected. Among the 134 hcv ab positive patients, 126 (67.7%) had detectable hcv ribonucleic acid (rna) Indicating chronic hcv infection; only 8 patients (2.21%) with chronic hcv infection ever initiated treatment. 

Conclusion: Nearly half of patients (47.7%) receiving office-based treatment with Buprenorphine for their opioid use disorder had a positive hepatitis c virus antibody screening test, although initiation of hcv treatment was nearly non-existent (2.21%)