Addiction specialists belong at the forefront of strategies to prevent and manage HCV and HBV infections.
People who inject drugs (PWID) represent the core of the hepatitis C virus (HCV) and hepatitis B virus (HBV) epidemic in many countries.
- In the United Kingdom (UK) and high income countries, 80-90% of new HCV cases occur among PWID1,2
- EU estimates of prevalence suggest that up to 12% of all PWID have HBV; while in PWID with HIV coinfection, the prevalence of HBV rises to 21%3
Considering these figures, healthcare professionals involved in addiction medicine belong at the forefront of HCV and HBV management and any attempts to eliminate the viruses will need to utilise existing medical infrastructures for PWID (e.g. community health centres, opioid substitution clinics and primary care professionals).4
Addiction medicine specialists are in a unique position to:5,6
assist people with HCV and/or HBV by helping to stabilise their lifestyles
correct misunderstandings about the disease
promote prevention and selfcare
support access to diagnosis and treatment
monitor for treatment side effects, and
providing support to remain adherent to treatment
Screening for HBV
Read more on high-risk populations, testing and interpreting results.
Information on who and when to vaccinate.
Assessment of people with Chronic HBV
Exploring the need for treatment, clinical history and indications for treatment and monitoring.
Long-term patient management
Recommendations for follow up in patients who have achieved sustained viral suppression, by patient population.
Drug resistance and salvage therapy
Exploring options for patients demonstrating non-adherence or non-response to treatment.
Discover ongoing elimination projects and models of care which include marginalised populations such as people who inject drugs (PWIDs).
Hepatitis C toolkit
Collated resources on prevention, management, screening tools and guidelines for HCV.
Hepatitis B toolkit
Collated resources on prevention, management, screening tools and guidelines for HBV.
- Grebley J. and Dore GJ. Can hepatitis C virus infection be eradicated in people who inject drugs? Antiviral Research 2014;104:62-72.
- Public Health England. HCV in England 2018 Headline data table. 2018. Available from: https://www.gov.uk/government/publications/hepatitis-c-in-the-uk (accessed November 2018).
- European Centre for Disease Prevention and Control. Hepatitis B and C epidemiology in selected population groups in the EU/EEA. Stockholm: ECDC; 2018.
- Bruggmann P., Litwin, AH. Models of care for the management of HCV among people who use drugs: one size does not fit all. Clin Infect Dis 2013;57 (Supp 2);S56–S61.
- Sylvestre D. Hepatitis C for addiction professionals. Addict Sci Clin Pract. 2007;4:34-41.
- Wodak A. An overview of hepatitis C clinical management in opiate pharmacotherapy settings. Available at: www.ashm.org.au/publications (accessed November 2018).
LID/IHQ/18-12//1048E DATE OF PREPARATION: MARCH 2019