Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7846
Revised: October 18, 2013
Accepted: November 2, 2013
Published online: November 28, 2013
Despite a high prevalence of hepatitis C virus (HCV) infection, the vast majority of persons who inject drugs (PWID) have not engaged in HCV care due to a large number of obstacles. Education about the infection among both PWID and providers remains an important challenge as does discrimination faced by PWID in conventional health care settings. Many providers also remain hesitant to prescribe antiviral therapy due to concerns about adherence and relapse to drug use resulting in reinfection. Presently, however, as a result of improvements in treatment efficacy combined with professional society and government endorsement of HCV treatment for PWID, a pressing need exists to develop strategies to engage these individuals into HCV care. In this article, we propose several strategies that can be pursued in an attempt to engage PWID into HCV management. We advocate that multidisciplinary approaches that utilize health care practitioners from a wide range of specialties, as well as co-localization of medical services, are strategies likely to result in increased numbers of PWID entering into HCV management. Pursuit of HCV therapy after stabilization through drug treatment is an additional strategy likely to increase PWID engagement into HCV care. The full impact of direct acting antivirals for HCV will only be realized if innovative approaches are pursued to engage all HCV infected individuals into treatment.
Core tip: Despite persons who inject drugs (PWIDs) representing the majority of the hepatitis C virus (HCV) disease burden, few receive treatment for HCV. Barriers to treatment uptake exist at multiple levels. Co-localization of HCV management with substance abuse facilities may result in greater treatment uptake for PWID.