Barriers to receiving hepatitis C treatment for people who inject drugs: Myths and evidence

AUTHORS

Peter Higgs 1 , * , Rachel Sacks-Davis 2 , Judy Gold 2 , Margaret Hellard 2

1 1) National Center in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney. 2) Center for Population Health, Burnet Institute, Melbourne. 3) School of Public Health and Preventive Medicine, Monash University, p.higgs@unsw.edu.au, Australia

2 1) Center for Population Health, Burnet Institute. 2) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

How to Cite: Higgs P, Sacks-Davis R, Gold J, Hellard M. Barriers to receiving hepatitis C treatment for people who inject drugs: Myths and evidence, Hepat Mon. Online ahead of Print ; 11(7):513-518.

ARTICLE INFORMATION

Hepatitis Monthly: 11 (7); 513-518
Article Type: Review Article
Received: August 25, 2010
Accepted: April 6, 2011

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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.
Objectives: We reviewed the literature to obtain an evidence base for these common exclusion criteria.
Materials and 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 treatment 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. 


  • Implication for health policy/practice/research/medical education:
    Making evidence-based HCV treatment decisions rather than ones based on preconceived ideas about people who deserve treatment for HCV is essential. Those involved in deciding to offer HCV treatment would do well to consider the results of this study which show that patient centred treatment is crucial.
  • Please cite this paper as:
    Higgs P, Sacks-Davis R, Gold J, Hellard M. Barriers to recivieng hepatitis C treatment for people who inject drugs: Myths and evidence. Hepat Mon. 2011;11(7):513-8.

© 2011 Kowsar M.P.Co. All rights reserved.


Keywords

Hepatitis C virus Interferon Drug users Alcohol Mental disorder

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