Effect of hepatitis C virus status on liver enzymes in opioid-dependent pregnant women maintained on opioid-agonist medication

Addiction. 2012 Nov;107 Suppl 1(0 1):91-7. doi: 10.1111/j.1360-0443.2012.04043.x.

Abstract

Aim: To examine hepatic enzyme test results throughout the course of pregnancy in women maintained on methadone or buprenorphine.

Design: Participants were randomized to either methadone or buprenorphine maintenance. Blood chemistry tests, including liver transaminases and hepatitis C virus (HCV) status, were determined every 4 weeks and once postpartum. As part of a planned secondary analysis, generalized mixed linear models were conducted with aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) as the dependent variables.

Setting: Six US sites and one European site that provided comprehensive treatment to pregnant opioid-dependent women.

Participants: A total of 175 opioid-dependent pregnant women enrolled in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study.

Findings: ALT, AST and GGT levels decreased for all subjects across pregnancy trimesters, rising slightly postpartum. HCV-positive subjects exhibited higher transaminases at all time-points compared to HCV-negative subjects, regardless of medication (all Ps < 0.05) condition. Both HCV-positive and negative buprenorphine-maintained participants exhibited lower GGT levels than those who were methadone-maintained (P < 0.05).

Conclusions: Neither methadone nor buprenorphine appear to have adverse hepatic effects in the treatment of pregnant opioid-dependent women.

Trial registration: ClinicalTrials.gov NCT00271219.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / therapeutic use*
  • Female
  • Hepatitis C / enzymology*
  • Hepatitis C / epidemiology
  • Humans
  • Linear Models
  • Liver / drug effects
  • Liver / enzymology
  • Liver Function Tests
  • Methadone / therapeutic use*
  • Opiate Substitution Treatment
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / enzymology*
  • Opioid-Related Disorders / epidemiology
  • Pregnancy
  • Pregnancy Trimesters
  • Transaminases / metabolism*
  • Young Adult
  • gamma-Glutamyltransferase / metabolism

Substances

  • Analgesics, Opioid
  • Buprenorphine
  • gamma-Glutamyltransferase
  • Transaminases
  • Methadone

Associated data

  • ClinicalTrials.gov/NCT00271219