Bridging Active Heroin Users to Hepatitis C Treatment Using Buprenorphine - 1

This is a prospective pilot safety study based on the hypothesis that active,
street-recruited heroin users can be successfully treated for hepatitis C after
stabilization on buprenorphine. Eligible subjects will be actively using heroin and have
hepatitis C viremia; screening will occur at street-based sites like syringe exchange
programs. Those who are eligible will sign informed consent, and then be asked to attend 3
weekly educational sessions about hepatitis C and addiction as well as undergo an intake
interview. After this, subjects will be inducted onto buprenorphine/naloxone combination
therapy (Suboxone) and receive this medication for 12-24 weeks. Once reaching the 12-24 week
study time point, subjects will have the option of a 12-week Suboxone taper, or instead of
undergoing 6-12 months of hepatitis C treatment with pegylated interferon and ribavirin
while being maintained on Suboxone. Once completing hepatitis C treatment, subjects will
undergo a 24-week Suboxone taper, or be transitioned to outpatient Suboxone therapy by a
medical provider.

Inclusion Criteria:

- Active heroin or other illicit opioid use

- Active hepatitis C

- No medical or psychiatric contraindications

- Able to sign informed consent

Exclusion Criteria:

- No opiate dependence

- Age <18

- Unable or uninterested in attending weekly group sessions