title: Overcoming barriers to prevention, care, and treatment of hepatitis C in illicit drug users.
abstract: 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.
authors.affiliation: Center for the Study of Hepatitis C, Weill Medical College of Cornell University, New York, New York, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Edlin
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Kresina
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Raymond
authors.forename: Michael R
authors.initials: MR
authors.lastname: Carden
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: Josiah D
authors.initials: JD
authors.lastname: Rich
authors.forename: Laura W
authors.initials: LW
authors.lastname: Cheever
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Cargill
mesh_terms: 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
chemical_list: D000998:Antiviral Agents