Buprenorphine Induction in Persons With Opioid Use Disorder Hospitalized with Acute Hepatitis A

J Addict Med. 2021 May-Jun;15(3):187-190. doi: 10.1097/ADM.0000000000000730.

Abstract

Background: It is not known whether buprenorphine/naloxone (bup/nx) can be safely initiated in hospitalized patients with acute hepatitis A infection. We assessed liver function and tolerability of bup/nx induction in patients with acute Hepatitis A Virus (HAV).

Methods: Retrospective review of patients (N = 31) admitted to a tertiary care facility for acute HAV who were evaluated by an addiction medicine consultant.

Results: No significant difference was seen in aspartate aminotransferase, alanine aminotransferase, total bilirubin, or INR trends in patients receiving bup/nx during hospitalization versus those not receiving bup/nx. Nausea was the most common reported symptom in patients receiving bup/nx.

Discussion and conclusions: With careful monitoring and induction dose adjustment, bup/nx can be administered to patients with acute HAV without hepatic encephalopathy. Similarly, patients on bup/nx before hospitalization should not have this medication held in the setting of acute HAV.

Scientific significance: This strategy may engage patients with acute HAV in treatment of OUD earlier and minimize disruptions in treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Buprenorphine* / therapeutic use
  • Buprenorphine, Naloxone Drug Combination / therapeutic use
  • Hepatitis A* / drug therapy
  • Humans
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Opiate Substitution Treatment
  • Opioid-Related Disorders* / drug therapy
  • Retrospective Studies

Substances

  • Buprenorphine, Naloxone Drug Combination
  • Narcotic Antagonists
  • Naloxone
  • Buprenorphine