Work

Toward Optimal Control of Hepatitis C Virus Infection in Persons With Substance Use Disorders

Year: 2017

Type: article

Abstract: The development of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection has revolutionized treatment of this condition and may lead to its elimination.Crucial to this objective is eradication from persons with substance use disorders (SUDs), who account for 68% to 80% of infections in developed countries (1).The HCV treatment cascade has failed to achieve high rates of viral eradication among this population for many reasons, including stigmatization of an HCV diagnosis; discomfort encountered at conventional health care settings; chaotic lifestyles; lack of HCV-related knowledge; and multiple comorbidities, including HIV, hepatitis B virus (HBV) infection, and polysubstance addiction.Physician reluctance to treat persons with SUDs and limited access to DAAs due to prescribing restrictions and high cost also hamper HCV treatment in this population (2).New approaches for persons with SUDs are required at every step in the HCV care paradigm.After a decade of decline, recent sharp increases in HCV incidence in persons with SUDs, accompanied by changes in demographic characteristics and the identification of places with high transmission rates, have renewed interest in HCV prevention (2).

Source: Annals of Internal Medicine

DOI: 10.7326/m16-2887

Authors: Andrew H. Talal, Dave L. Thomas, Jessica L. Reynolds, Jag H. Khalsa