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Overcoming barriers to prevention, care, and treatment of hepatitis C in illicit drug users.

Edlin BR, Kresina TF, Raymond DB, Carden MR, Gourevitch MN, Rich JD, Cheever LW, Cargill VA.

Center for the Study of Hepatitis C, Weill Medical College of Cornell University, New York, New York, USA.

Injection drug use accounts for most of the incident infections with hepatitis C virus (HCV) in the United States and other developed countries. HCV infection is a complex and challenging medical condition in injection drug users (IDUs). Elements of care for hepatitis C in illicit drug users include prevention counseling and education; screening for transmission risk behavior; testing for HCV and human immunodeficiency virus infection; vaccination against hepatitis A and B viruses; evaluation for comorbidities; coordination of substance-abuse treatment services, psychiatric care, and social support; evaluation of liver disease; and interferon-based treatment for HCV infection. Caring for patients who use illicit drugs presents challenges to the health-care team that require patience, experience, and an understanding of the dynamics of substance use and addiction. Nonetheless, programs are successfully integrating hepatitis C care for IDUs into health-care settings, including primary care, methadone treatment and other substance-abuse treatment programs, infectious disease clinics, and clinics in correctional facilities.

Publication Types:
PMID: 15768335 [PubMed - indexed for MEDLINE]

PMCID: PMC1510897