Effect of Buprenorphine on Liver Function Tests for Patients Undergoing Long-term Maintenance Treatment

Background: We wanted to study the long-term effect of buprenorphine on hepatotoxicity. Methods: We conducted observational retrospective chart reviews for patients undergoing office-based buprenorphine maintenance treatment at the Atlanta VA Medical Center (VAMC). Thirty-one patient charts were selected for reviews after exclusion of patients who did not have norbuprenorphine in their urine to confirm their compliance with treatment. Results: Those patients have been undergoing treatment for an average duration of 28 months (+/- 22). Being hepatitis C positive and being under treatment for a longer duration are predictors for elevated aspartate aminotransferase (R-2 adjusted for degrees of freedom= 49). Being hepatitis C positive and being under treatment for a longer duration (R-2 adjusted for degrees of freedom= 49), being hepatitis C positive and older in age (R-2 adjusted for degrees of freedom= 50), and being hepatitis C positive and taking heroin as a primary drug of choice (R-2 adjusted for degrees of freedom= 44) are predictors for elevated alanine aminotransferase (ALT). In this study, the elevations of aspartate aminotransferase/alanine aminotransferase from the time of admission to most recently were < 2 times normal. Conclusions and Scientific Significance: This study confirms the safety of buprenorphine and its low risk for hepatotoxicity even after being under treatment for an extended period of time. Our study confirms previous reports on the increased risk for elevated liver function tests for patients on buprenorphine who are hepatitis C positive. However, in our study the elevation of liver function tests in this population was not of clinical significance.