Buprenorphine safe for use in Hospitalized patients with Acute Hepatitis A: Study

Hepatitis A is an inflammation of the liver that can cause mild to severe illness. The hepatitis A virus (HAV) is transmitted by ingesting contaminated food and water or direct contact with an infectious person. Patients are admitted if they are showing any signs or symptoms suggestive of severe complications. Buprenorphine is FDA-approved for acute pain, chronic pain, and opioid dependence. It is not known whether buprenorphine/naloxone (bup/nx) can be safely initiated in hospitalized patients with acute hepatitis A infection.

A group of researchers from U.S.A assessed liver function and tolerability of buprenorphine/naloxone (bup/nx) induction in patients with acute Hepatitis A Virus (HAV).

The researchers conducted retrospective review of patients (N = 31) admitted to a tertiary care facility for acute Hepatitis A Virus (HAV) who were evaluated by an addiction medicine consultant.

The results of the study are as follows:

• No significant difference was seen in aspartate aminotransferase, alanine aminotransferase, total bilirubin, or INR trends in patients receiving buprenorphine/naloxone (bup/nx) during hospitalization versus those not receiving buprenorphine/naloxone (bup/nx).
• Nausea was the most commonly reported symptom in patients receiving buprenorphine/naloxone (bup/nx).

Thus, the researchers concluded that with careful monitoring and induction dose adjustment, buprenorphine/naloxone (bup/nx) could be administered to patients with acute HAV without hepatic encephalopathy. Similarly, patients on buprenorphine/naloxone (bup/nx) before hospitalization should not have this medication held in the setting of acute Hepatitis A Virus (HAV). And that this strategy may engage patients with acute HAV in treatment of OUD earlier and minimize disruptions in treatment.

Reference:

A study titled "Buprenorphine Induction in Persons With Opioid Use Disorder Hospitalized with Acute Hepatitis A" by Oller D et al. published in the J Addict Med.

DOI: 10.1097/ADM.0000000000000730