Hepatitis C treatment for injection drug users: a review of the available evidence.
Globally, approximately 90% of new hepatitis C infections are attributed to injection drug use, but there is a continuing reluctance to treat injection drug users (IDUs). There is evidence that a sizeable proportion of IDUs who begin hepatitis C treatment achieve a sustained virological response (SVR). In chronic hepatitis C treatment trials, the SVR rate among IDUs appears to be comparable to rates among non-IDUs; in trials prescribing pegylated interferon plus ribavirin, the median rate of SVR among IDUs was 54.3% (range, 18.1%-94.1%), compared with 54%-63% in the large treatment trials. Few trials of acute hepatitis C treatment report on outcomes in IDUs; however, among these trials, the SVR among IDUs was 68.5% (n=89), compared with 81.5% among non-IDUs (n=65). Additional studies are required to determine the optimal circumstances for treatment (e.g., enrollment in drug treatment, the requirement of a period of abstinence from injection drug use, or the establishment of multidisciplinary treatment programs).
Hellard
Margaret
M
Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC 3004, Australia. hellard@burnet.edu.au
Sacks-Davis
Rachel
R
Gold
Judy
J
D000998:Antiviral Agents / Q000627:therapeutic use*; D055030:Drug Users; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome
D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons