Does Hep C treatment work for IDUs?

Programs working with IDUs should be providing clients with treatment for Hep C (and possibly vaccination for Hep A and B. There is no Hep C vaccine yet.)

But there is some resistance to this goal from those who question the efficacy of treatment for active drug users. The vast majority of new Hep C cases in the world are among IDUs, so understanding Hep treatment options for IDUs is critically important.

The article below presents data showing that Hep C treatment works for active drug users - important information for our advocacy and implementation, to improve the health of our IDU clients.

Cheers
Rob



Clinical Infectious Diseases 2009;49:561?573

C 2009 by the Infectious Diseases Society of America.

DOI: 10.1086/600304

REVIEW ARTICLE

Hepatitis C Treatment for Injection Drug Users: A Review of the Available Evidence

Margaret Hellard, Rachel Sacks-Davis, and Judy Gold

Centre for Population Health, Burnet Institute, Melbourne, Australia

Globally, 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%, compared with 81.5% among non-IDUs. 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).

Received 30 October 2008; accepted 18 March 2009; electronically published 9 July 2009.

Reprints or correspondence: A/Prof M. Hellard, Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC 3004, Australia (hellard@burnet.edu.au).