We Must Do Better: Addressing HCV Treatment Barriers in Persons Who Inject Drugs in the United States

J Infect Dis. 2020 Nov 27;222(Suppl 9):S773-S781. doi: 10.1093/infdis/jiaa574.

Abstract

The opioid epidemic in the United States, along with a lack of adequate harm reduction services, has contributed to a sharp rise in hepatitis C virus (HCV) infections. Despite considerable evidence of the effectiveness of HCV treatment in people who inject drugs (PWID), and recommendations from clinical guidelines to prioritize treatment in PWID, there are multiple barriers to broad uptake of HCV treatment. These barriers exist at the systems level, as well as at the level of medical providers and patients. Interventions to remove treatment barriers in the United States include harm reduction services, simplifying HCV testing algorithms, improved linkage to HCV care services, and application of new treatment models including colocating services at substance use disorder treatment programs. By following the lead of other countries who have addressed the barriers to HCV treatment, the United States has opportunities to do better in addressing the consequences of the opioid epidemic, including chronic HCV infection.

Keywords: barriers to care; hepatitis C; people who inject drugs.

MeSH terms

  • Algorithms
  • Antiviral Agents / therapeutic use*
  • Disease Eradication
  • Hepatitis C / drug therapy*
  • Humans
  • Patient Acceptance of Health Care
  • Practice Guidelines as Topic
  • Substance Abuse, Intravenous / drug therapy
  • Substance Abuse, Intravenous / epidemiology*
  • United States / epidemiology

Substances

  • Antiviral Agents