title: A systematic approach to the treatment of HIV and hepatitis C virus infection in the inner city: a Canadian perspective.
abstract: The treatment of injection drug users (IDUs) coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) presents multiple challenges, many of which could be addressed by the development of directly observed therapy programs. This is made all the more feasible by the validation of once-daily treatment regimens for HIV. We have demonstrated that virological suppression can be achieved and maintained in as many as 80% of active IDUs who have received highly active antiretroviral therapy for 48 months. This approach has now been validated in first- and second-line therapy, as well as for the treatment of bacterial infections in this population, achieving therapeutic results similar to those reported in the general population. The model is now being applied to the treatment of HCV infection, focusing on patients with infection due to HCV genotype 2 or 3, in whom the likelihood of response may exceed 80%. Our ultimate goal is to ensure that, even in treating IDUs in the inner city, no patient is left behind.
authors.affiliation: Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. bconway@interchange.ubc.ca
authors.forename: Brian
authors.initials: B
authors.lastname: Conway
authors.forename: Jason
authors.initials: J
authors.lastname: Grebely
authors.forename: Harout
authors.initials: H
authors.lastname: Tossonian
authors.forename: Dennis
authors.initials: D
authors.lastname: Lefebvre
authors.forename: Stanley
authors.initials: S
authors.lastname: de Vlaming
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D002170:Canada; D004347:Drug Interactions; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D011204:Poverty Areas; D015819:Substance Abuse, Intravenous / Q000150:complications; D014505:Urban Population