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

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.