title: Barriers to receiving hepatitis C treatment for people who inject drugs: Myths and evidence.
abstract: BACKGROUND
  Alcohol consumption, current injecting drug use, and pre-existing mental illness have been identified as 3 of the main reasons for excluding patients from treatment for hepatitis C.
  
  
  OBJECTIVE
  We reviewed the literature to obtain an evidence base for these common exclusion criteria.
  
  
  METHODS
  We reviewed original research and meta-analyses investigating the effects of alcohol consumption, current injecting drug use, and pre-existing mental illness.
  
  
  RESULTS
  We identified 66 study reports relevant to the review, but found only limited evidence to support withholding of treatment on the basis of the 3 previously mentioned exclusion criteria.
  
  
  CONCLUSIONS
  Currently, there is a lack of evidence for many of the barriers faced by patients in availing treatment for hepatitis C. Adherence to treat routine was found to be a better predictor of sustained virological response than injecting drug or alcohol consumption during treatment period or the presence of a pre-existing mental disorder. Although several challenges remain, we need to ensure that treatment decisions are based on the best available evidence and the treatment is performed appropriately on a case-by-case basis.
authors.affiliation: National Center in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.
authors.forename: Peter
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authors.lastname: Higgs
authors.forename: Rachel
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authors.lastname: Sacks-Davis
authors.forename: Judy
authors.initials: J
authors.lastname: Gold
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
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