***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND In developed countries hepatitis C is prevalently transmitted by intravenous drug users ( IDUs ) . The problems associated with management of HCV hepatitis in these patients have , in the past , discouraged treatment . AIM To evaluate efficacy , safety and tolerability of a st and ard Peginterferon ( Peg-IFN ) alpha-2b or alpha-2a plus Ribavirin treatment in IDUs who were receiving methadone or buprenorphine .  METHODS A multi-centre prospect i ve observational study performed from September 2003 to September 2006 in Central Italy ( Umbria and Marches regions ) . A shared care model of HCV management was used which integrated a multidimensional , multidisciplinary approach . RESULTS Sixty-five subjects were evaluated and 52 satisfied inclusion criteria . Forty-five completed treatment ( 25 with Peg-IFN alpha-2b , 20 with Peg-IFN alpha-2a ) , a total of 37 showed a biochemical/virological response at the end of treatment ( ITT 71.1 % ) , 26 had a sustained virological response ( ITT 50 % ; 38.4 % of cases genotype 1 - 4 , 61.6 % genotype 3 - 2 ) . CONCLUSIONS The results indicate that patients on maintenance treatment with methadone/buprenorphine  can be treated for HCV . The success rate was fairly good ; tolerability and side effects were similar to those reported in non-IDU patients . Close cooperation with specialists in drug addiction and psychiatrists is however essential for success AIM To evaluate the effect of a multi-disciplinary st and ardized management model on the efficacy of pegylated (Peg)-interferon alpha-2b plus ribavirin treatment of chronic hepatitis C in drug addicts undergoing substitutive or antagonist therapy . DESIGN Observational prospect i ve multi-centre study . SETTING Six clinical infectious disease centres in collaboration with 11 drug dependency units ( DDU ) in five Italian regions . PARTICIPANTS Intravenous drug users affected by chronic hepatitis C engaged in detoxification programmes . METHODS Application of a multi-disciplinary st and ardized management model for HCV treatment involving DDU operators , psychologists or psychiatrists and infectious disease specialists . MEASUREMENTS Very early , early , end-of-treatment and sustained virological response to Peg-interferon alpha-2b plus ribavirin . FINDINGS Fifty-three subjects were studied [ 43.4 % with hepatitis C virus ( HCV ) genotypes 1 or 4 ] . Intent-to-treat analysis showed an end-of-treatment virological response in 58.5 % of patients ( 39.1 % genotypes 1 or 4 ; 73.4 % genotype 3 ) and a sustained virological response in 54.7 % ( 34.8 % genotypes 1 or 4 ; 70.0 % genotype 3 ) . There were 19 ( 35.8 % ) dropouts and three ( 5.7 % ) non-responders : one genotype 1 and two genotype 4 . Two ( 3.8 % ) patients relapsed : genotypes 1 and 3 . On-treatment analysis showed negative HCV-RNA in 40 ( 93.1 % ) of 43 subjects who completed the first 12 treatment weeks and in 35 who completed the first 24 treatment weeks . All subjects with an end-of-treatment response , except one with genotype 3 infection , had a sustained response . CONCLUSIONS Our data show that antiviral treatment in the context of a multi-disciplinary st and ardized management model helps many HCV-positive drug addicts achieve a good virological response BACKGROUND / AIMS Treatment with interferon-alpha ( IFN-alpha ) may eradicate HCV in most acute hepatitis C patients , thus preventing chronic hepatitis and avoiding less efficacious combination therapy . METHODS In a prospect i ve study , we evaluated the impact of barriers to successful start and completion of treatment of acute and subacute ( < 12 months from infection ) hepatitis C with pegylated IFN-alpha2b , 1.5 microg/kg , QW , for 24 weeks . RESULTS Out of 27 patients ( 22 were active intravenous drug users [ IVDU ] ) , 5 cleared HCV spontaneously . Antiviral treatment was indicated in 22 patients : six refused therapy for fear of side effects , whereas two others were lost to observation . Eight patients completed the treatment or received > 80 % of the scheduled drug : seven ( 88 % ) were sustained virological responders 24 weeks after the end of treatment . Six patients ( all IVDU ) stopped prematurely due to side effects : only one had a sustained virological response . Based on an intent-to-treat analysis , and considering all 14 patients in whom at least one dose of drug was administered , only 8 ( 57 % ) became sustained virological responders . CONCLUSIONS Treatment of acute hepatitis C with pegylated IFN-alpha is highly beneficial , but its effectiveness is affected by a poor rate of acceptance and /or adherence to currently available regimens , especially in IVDU and women BACKGROUND A sustained virological response ( SVR ) rate of 41 % has been achieved with interferon alfa-2b plus ribavirin therapy of chronic hepatitis C. In this r and omised trial , peginterferon alfa-2b plus ribavirin was compared with interferon alfa-2b plus ribavirin . METHODS 1530 patients with chronic hepatitis C were assigned interferon alfa-2b ( 3 MU subcutaneously three times per week ) plus ribavirin 1000 - 1200 mg/day orally , peginterferon alfa-2b 1.5 microg/kg each week plus 800 mg/day ribavirin , or peginterferon alfa-2b 1.5 microg/kg per week for 4 weeks then 0.5 microg/kg per week plus ribavirin 1000 - 1200 mg/day for 48 weeks . The primary endpoint was the SVR rate ( undetectable hepatitis C virus [ HCV ] RNA in serum at 24-week follow-up ) . Analyses were based on patients who received at least one dose of study medication . FINDINGS The SVR rate was significantly higher ( p=0.01 for both comparisons ) in the higher-dose peginterferon group ( 274/511 [ 54 % ] ) than in the lower-dose peginterferon ( 244/514 [ 47 % ] ) or interferon ( 235/505 [ 47 % ] ) groups . Among patients with HCV genotype 1 infection , the corresponding SVR rates were 42 % ( 145/348 ) , 34 % ( 118/349 ) , and 33 % ( 114/343 ) . The rate for patients with genotype 2 and 3 infections was about 80 % for all treatment groups . Secondary analyses identified bodyweight as an important predictor of SVR , prompting comparison of the interferon regimens after adjusting ribavirin for bodyweight ( mg/kg ) . Side-effect profiles were similar between the treatment groups . INTERPRETATION In patients with chronic hepatitis C , the most effective therapy is the combination of peginterferon alfa-2b 1.5 microg/kg per week plus ribavirin . The benefit is mostly achieved in patients with HCV genotype 1 infections Background : Though patients in opiate substitution programs are commonly infected with HCV , due to safety and efficacy concerns , they are rarely treated with interferon and ribavirin . Methods : In a multicenter study , HCV-infected patients in opiate maintenance treatment programs received 180 μg pegylated interferon-alfa-2a once weekly , plus daily ribavirin for 24 weeks ( genotypes 2 , 3 ) , or 48 weeks ( genotypes 1 , 4 ) . Results : Of the 67 patients enrolled , 31 ( 46 % ) had HCV genotypes 1 or 4 , and 36 ( 54 % ) had genotypes 2 or 3 . Intent-to-treat analysis showed end-of-treatment virologic response in 75 % of patients ( 81 % of genotypes 2 or 3 ; 65 % of genotypes 1 or 4 ) , and a sustained virologic response in 61 % of patients ( 72 % of genotypes 2 or 3 ; 48 % of genotypes 1 or 4 ) . Fifteen patients ( 22 % ) did not complete the study , in 5 ( 8 % ) cases because of severe adverse events . Conclusions : Drug users with chronic HCV infection , regularly attending an opiate maintenance program in which close collaboration between hepatologists/internists and addiction specialists is assured , can be treated effectively and safely  with pegylated interferon-alfa-2a and ribavirin . Treatment results are very similar to those in other patient groups , and thus therapy should also be considered for this population BACKGROUND A minority of HIV/HCV coinfected patients with opiate addiction undergo HCV treatment . HCV therapy for HCV-monoinfected methadone maintenance ( MM ) recipients is safe and effective . We evaluated treatment efficacy and adherence to pegylated interferon ( pegIFN ) among HIV/HCV coinfected MM recipients . METHODS HCV treatment-naïve , HIV-infected persons 18 - 65 years with chronic HCV genotype 1 on MM were prospect ively enrolled in an HCV treatment study at two HIV clinics . At weekly visits pegIFN alfa-2a injections were directly administered . Daily MM recipients had morning ribavirin delivered with methadone at off-site methadone clinics . Weekly take-home MM recipients took ribavirin unsupervised . Target enrollment was 30 participants . RESULTS During 18 recruitment months , 11 participants were enrolled , 6 of whom received daily methadone . Mean age was 46 , 64 % were female , 5 were Caucasian , 4 Black and 2 Hispanic . At baseline , 82 % had high HCV RNA and 55 % had stage 2 fibrosis or greater . The majority ( 91 % ) were on HAART , and 82 % had undetectable HIV RNA with a median CD4(+ ) of 508cells/μL. All had polysubstance use history , non-substance-based psychiatric diagnoses and were on psychotropic medications pre-enrollment . Two ( 18 % ) participants achieved a Sustained Virologic Response ( SVR ) . Two completed 48 treatment weeks , 5 were withdrawn due to adverse events , 2 dropped out prematurely and 2 had treatment discontinued for virologic non-response . Of on-treatment weeks , adherence to pegIFN was > 99 % . CONCLUSIONS SVR rate was comparable to historic controls for coinfected genotype 1 patients , with optimal pegIFN adherence . Adverse effects often prevented therapy completion in this population BACKGROUND : Adherence to chronic hepatitis C ( CHC ) treatment may be particularly challenging in methadone maintenance patients . We assessed the safety , tolerability , and efficacy of peginterferon alfa-2a/ribavirin treatment in methadone maintenance patients previously untreated for CHC . METHODS : Patients were r and omized 1:1 to direct observed therapy ( DOT ) or  self-administration ( SA )  of peginterferon alfa-2a . DOT patients were seen weekly at methadone clinics ; SA patients were seen less frequently , only at investigative sites . Genotype 1-infected patients were treated for 48 wk with peginterferon alfa-2a ( 180 μg/wk)/ribavirin ( 1,000/1,200 mg/day ) ; genotypes 2- and 3-infected patients were treated for 24 wk with peginterferon alfa-2a ( 180 μg/wk)/ribavirin ( 800 mg/day ) . RESULTS : Based on defined efficacy stopping rules , 77 % ( 37/48 ) completed their targeted length of treatment , and 44 % ( 21/48 ) achieved sustained virologic response ( SVR ) . Two DOT and 3 SA patients were withdrawn for safety reasons and 6 and 9 , respectively , for nonsafety reasons . Over 60 % and 50 % of each group were > 80 % compliant with the planned cumulative doses of peginterferon alfa-2a and ribavirin , respectively , and over 60 % with overall treatment duration . SVR rates were 54 % ( 13/24 ) for DOT and 33 % ( 8/24 ) for SA ; 23 % ( 3/13 ) and 38 % ( 6/16 ) , respectively , for genotype 1 and 91 % ( 10/11 ) and 25 % ( 2/8 ) , respectively , for genotypes 2 and 3 . Stepwise logistic regression analysis , showed that DOT ( vs SA ; OR 3.27 , 95 % CI 0.90–11.91 , P= 0.073 ) and Caucasian race ( vs Other 
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Treatment of addiction during HCV therapy results in higher treatment completion .
Our pooled SVR rate is similar to that obtained in registration trials in the general population .