Format

Send to

Choose Destination
Int J Drug Policy. 2015 Oct;26(10):1028-38. doi: 10.1016/j.drugpo.2015.07.005. Epub 2015 Jul 17.

Recommendations for the management of hepatitis C virus infection among people who inject drugs.

Author information

1
Kirby Institute, UNSW Australia, Sydney, Australia. Electronic address: jgrebely@kirby.unsw.edu.au.
2
Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium; Department of Hepatology, UZ Leuven, Leuven, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Program, Hasselt University, Hasselt, Belgium.
3
Arud Centres of Addiction Medicine, Zurich, Switzerland.
4
A.M. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
5
Ludwig-Maximilians-University, Munich, Germany; Praxiszentrum im Tal Munich, Munich, Germany.
6
CRCHUM, Université de Montréal, Montreal, Canada.
7
International Network of People who Use Drugs, Canberra, Australia.
8
Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway.
9
University of Toronto, Toronto, Canada.
10
Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
11
School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom.
12
European Liver Patients Association, Cologne, Germany.
13
Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
14
Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Australia, Sydney, Australia.
15
Center for HIV and Hepatogastroenterology, Düsseldorf, Germany.
16
Department of Research, Cluster Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Department of Internal Medicine, CINIMA, Academic Medical Centre, Amsterdam, The Netherlands.
17
Treatment Action Group, New York, United States.
18
Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, Essen, Germany; Department of Psychiatry and Psychotherapy-CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany.
19
Department of Medicine, Brown University, Providence, RI, United States.
20
Kirby Institute, UNSW Australia, Sydney, Australia.

Abstract

In high income countries, the majority of new and existing hepatitis C virus (HCV) infections occur among people who inject drugs (PWID). In many low and middle income countries large HCV epidemics have also emerged among PWID populations. The burden of HCV-related liver disease among PWID is increasing, but treatment uptake remains extremely low. There are a number of barriers to care which should be considered and systematically addressed, but should not exclude PWID from HCV treatment. The rapid development of interferon-free direct-acting antiviral (DAA) therapy for HCV infection has brought considerable optimism to the HCV sector, with the realistic hope that therapeutic intervention will soon provide near optimal efficacy with well-tolerated, short duration, all oral regimens. Further, it has been clearly demonstrated that HCV treatment is safe and effective across a broad range of multidisciplinary healthcare settings. Given the burden of HCV-related disease among PWID, strategies to enhance HCV assessment and treatment in this group are urgently needed. These recommendations demonstrate that treatment among PWID is feasible and provide a framework for HCV assessment and care. Further research is needed to evaluate strategies to enhance testing, linkage to care, treatment, adherence, viral cure, and prevent HCV reinfection among PWID, particularly as new interferon-free DAA treatments for HCV infection become available.

KEYWORDS:

Drug users; Guidelines; HCV; HIV; Injecting; Injection; PWID

PMID:
26282715
PMCID:
PMC6130980
DOI:
10.1016/j.drugpo.2015.07.005
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center