Overcoming barriers to prevention, care, and treatment of hepatitis C in illicit drug users.
Injection drug use accounts for most of the incident infections with hepatitis C virus (HCV) in the United States and other developed countries. HCV infection is a complex and challenging medical condition in injection drug users (IDUs). Elements of care for hepatitis C in illicit drug users include prevention counseling and education; screening for transmission risk behavior; testing for HCV and human immunodeficiency virus infection; vaccination against hepatitis A and B viruses; evaluation for comorbidities; coordination of substance-abuse treatment services, psychiatric care, and social support; evaluation of liver disease; and interferon-based treatment for HCV infection. Caring for patients who use illicit drugs presents challenges to the health-care team that require patience, experience, and an understanding of the dynamics of substance use and addiction. Nonetheless, programs are successfully integrating hepatitis C care for IDUs into health-care settings, including primary care, methadone treatment and other substance-abuse treatment programs, infectious disease clinics, and clinics in correctional facilities.
Edlin
Brian R
BR
Center for the Study of Hepatitis C, Weill Medical College of Cornell University, New York, New York, USA.
Kresina
Thomas F
TF
Raymond
Daniel B
DB
Carden
Michael R
MR
Gourevitch
Marc N
MN
Rich
Josiah D
JD
Cheever
Laura W
LW
Cargill
Victoria A
VA
D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control; D000998:Antiviral Agents / Q000627:therapeutic use; D003695:Delivery of Health Care; D015658:HIV Infections / Q000150:complications; D006506:Hepatitis A / Q000517:prevention & control; D006509:Hepatitis B / Q000517:prevention & control; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008605:Mental Health Services; D010349:Patient Compliance; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000628:therapy; D014611:Vaccination
D000998:Antiviral Agents