Until recently, HCV treatment guidelines excluded people who inject drugs, due to concerns about poor adherence, adverse events and re-infection. However, successful HCV treatment studies among this population have challenged this paradigm. The new international guidelines present evidence-based recommendations for treating HCV among individuals who inject drugs with appropriate evaluation and support.
Taylor is also lead author on a separate paper, appearing in the same supplement of Clinical Infectious Diseases, which focuses on the need for improved HCV care of another subset of the HCV-infected population: those who inject drugs and are also infected with HIV.
Chronic HCV infection has become a leading cause of non-AIDS related illness and death among individuals infected with HIV. Due to overlapping routes of transmission, dual infection is common: in the United States, 30 percent of HIV-infected people have chronic HCV, which is spread via contaminated blood, often through injection drug use. However, newer research suggests it may also be transmitted sexually among HIV-infected men who have sex with other men.
"HIV-infected individuals contending with injection drug use are the most likely to be affected by HCV, but the least likely to have access to treatment for HCV," said Taylor. "They should have equal and universal access to HIV/AIDS, HCV and addiction prevention, care and treatment."
She says essential but basic steps include improving prevention and screening for both infections and engaging co-infected individuals who inject drugs in HIV and HCV care early after diagnoses.
"The benefits of therapeutic advances in HCV will be limited for this group until barriers such as cost and access are overcome," she added. "Even with HCV cure rates approaching 100 percent with newer medications, effectiveness at population level will require
|Contact: Jessica Collins Grimes|