- Hepatitis C treatment has been shown to be safe and effective in people who inject drugs (PWID), with an increase in quality of life after sustained virologic response (SVR).
Why this matters
- PWID are a priority population for the scale-up of HCV testing, linkage to care, and treatment, given the high burden of HCV in this population.
- There are restrictions for the reimbursement of direct-acting antivirals (DAA) therapy for people with ongoing drug use in the USA and Europe.
- Reinfection and adherence to treatment are reported as the most important concerns among clinicians .
- There are 6 million PWID left to be treated .
- HCV infection needs to cured in order to prevent the complications of HCV-related liver and extra-hepatic diseases, including hepatic necro-inflammation, fibrosis, cirrhosis, decompensation of cirrhosis, hepatocellular carcinoma, and death .
- It is important to develop patient-reported measures for PWID undertaking DAAs .
- Under clinical trial conditions, SVR12 rates that exceed 90% can be achieved with currently available, simple, well-tolerated oral therapies directed against HCV infection, as long as patients are able to complete treatment and follow-up, and treatment starts can be maintained .
- Social treatment among PWID will only be achieved if healthcare systems are used as agents of social change .
- The HCV infection cure improves quality of life, removes stigma, and prevents onward transmission of HCV .
- Patient-reported measures might be even more important for patient groups that typically experience marginalization and lesser standing in society .
- There is a need for careful engagement with vulnerable clients, and the choice/logic of care should be determined by them .
- Studies needed to access rates and patterns of recurrent hepatocellular carcinoma.
- Lack of a best model of care for patients with mild fibrosis who achieve an SVR.
- Carla Treloar, Professor at the University of South Wales, Sydney, Australia, added that, “My work really tries to look at what is beyond the cure of hepatitis C; what are the important things in people’s lives? What do they worry about: some of the things are related to hepatitis C like liver health and test results, and other things are bigger and broader: hepatitis C cure to people with structural disadvantages. If we can, we should try to think about on how to address that along way with hepatitis C treatment.”