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

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.