A study on effect of buprenorphine- naloxone maintenance treatment on liver function in opioid dependence patients
Buprenorphine- Naloxone Treatment and Liver Function Tests
Keywords:
opioid dependence, buprenorphine–naloxone, liver function tests, hepatic enzymes, maintenance treatmentAbstract
Background: Buprenorphine–naloxone is widely used for maintenance treatment of opioid dependence. Although generally well tolerated, its potential effects on liver function warrant attention, particularly during long-term treatment. Evidence regarding hepatic biochemical abnormalities among patients receiving maintenance treatment remains limited.
Aim: To assess liver function parameters in patients with opioid dependence receiving buprenorphine–naloxone maintenance treatment and to examine their association with the prescribed dose.
Methods: This cross-sectional study was conducted at the Outpatient Opioid Assisted Treatment Clinic, Institute of Mental Health, Amritsar, Punjab. A total of 150 patients aged 18–60 years who had received buprenorphine–naloxone maintenance treatment for at least six months were included. Patients with identified HIV, hepatitis B or C infection, specified psychiatric comorbidities, or recent use of other psychoactive substances were excluded. Liver function parameters, including total and direct bilirubin, SGOT, SGPT, alkaline phosphatase, total protein, albumin, and globulin, were assessed. Spearman’s rank correlation analysis was performed to examine the associations between the prescribed dose and liver function parameters.
Results: Elevated total and direct bilirubin levels were observed in 10% of participants each. SGOT was elevated in 12.7%, while SGPT was elevated in 24%, representing the most frequently observed biochemical abnormality. Mean SGOT and SGPT levels were 28.42 ± 14.89 IU/L and 37.75 ± 19.62 IU/L, respectively. No statistically significant correlations were observed between prescribed dose and total bilirubin, direct bilirubin, SGOT, SGPT, alkaline phosphatase, total protein, or globulin. The correlation between the prescribed dose and serum albumin was borderline (ρ = −0.160, p = 0.050).
Conclusion: Liver biochemical abnormalities were observed in a proportion of patients receiving buprenorphine–naloxone maintenance treatment. No consistent association between prescribed dose and liver function parameters was demonstrated, highlighting the importance of continued clinical monitoring during maintenance treatment.
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