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

HBV

Read more on high-risk populations, testing and interpreting results. 

HBV prevention

HBV

Information on who and when to vaccinate.

Assessment of people with Chronic HBV

HBV

Exploring the need for treatment, clinical history and indications for treatment and monitoring. 

Long-term patient management

HCV

Recommendations for follow up in patients who have achieved sustained viral suppression, by patient population.

Drug resistance and salvage therapy

HCV

Exploring options for patients demonstrating non-adherence or non-response to treatment. 

Elimination projects

HCV

Discover ongoing elimination projects and models of care which include marginalised populations such as people who inject drugs (PWIDs).

Hepatitis C toolkit

HCV

Collated resources on prevention, management, screening tools and guidelines for HCV.

Hepatitis B toolkit

HBV

Collated resources on prevention, management, screening tools and guidelines for HBV.

References

  1. Grebley J. and Dore GJ. Can hepatitis C virus infection be eradicated in people who inject drugs? Antiviral Research 2014;104:62-72.
  2. 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).
  3. European Centre for Disease Prevention and Control. Hepatitis B and C epidemiology in selected population groups in the EU/EEA. Stockholm: ECDC; 2018.
  4. 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.
  5. Sylvestre D. Hepatitis C for addiction professionals. Addict Sci Clin Pract. 2007;4:34-41.
  6. 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