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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17971

Title: Eligibility of persons who inject drugs for treatment of hepatitis C virus infection
Authors: ARAIN, Amber
Issue Date: 2014
Citation: WORLD JOURNAL OF GASTROENTEROLOGY, 20 (36), p. 12722-12733
Abstract: In this decade, an increase is expected in end-stage liver disease and hepatocellular carcinoma, most commonly caused by hepatitis C virus (HCV) infection. Although people who inject drugs (PWID) are the major source for HCV infection, they were excluded from antiviral treatments until recently. Nowadays there is incontrovertible evidence in favor of treating these patients, and substitution therapy and active substance use are no longer contraindications for antiviral treatment. The viral clearance in PWID after HCV antiviral treatment with interferon or pegylated interferon combined with ribavirin is comparable to the viral clearance in non-substance users. Furthermore, multidisciplinary approaches to delivering treatment to PWID are advised, and their treatment should be considered on an individualized basis. To prevent the spread of HCV in the PWID community, recent active PWID are eligible for treatment in combination with needle exchange programs and substitution therapy. As the rate of HCV reinfection is low after HCV antiviral treatment, there is no need to withhold HCV treatment due to concerns about reinfection alone. Despite the advances in treatment efficacies and data supporting their success, HCV assessment of PWID and initiation of antiviral treatment remains low. However, the proportion of PWID assessed and treated for HCV is increasing, which can be further enhanced by understanding the barriers to and facilitators of HCV care. Removing stigmatization and implementing peer support and group treatment strategies, in conjunction with greater involvement by nurse educators/practitioners, will promote greater treatment seeking and adherence by PWID. Moreover, screening can be facilitated by noninvasive methods for detecting HCV antibodies and assessing liver fibrosis stages. Recently, HCV clearance has become a major endpoint in the war against drugs for the Global Commission on Drug Policy. This review highlights the most recent evidence concerning HCV infection and treatment strategies in PWID. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Notes: [Arain, Amber; Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, B-3600 Genk, Belgium. [Arain, Amber; Robaeys, Geert] Hasselt Univ, Fac Med & Life Sci, B-3590 Diepenbeek, Belgium. [Robaeys, Geert] UZ Leuven, Dept Hepatol, B-3000 Leuven, Belgium.
URI: http://hdl.handle.net/1942/17971
DOI: 10.3748/wjg.v20.i36.12722
ISI #: 000343880900002
ISSN: 1007-9327
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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