Call for public health intervention to treat young injection drug users infected with the hepatitis C virus

In a recent study published in the journal Clinical Infectious Diseases, scientists from New York City, Baltimore, Seattle, and San Diego called for an immediate public health intervention to treat young injection drug users infected with the hepatitis C virus (HCV).

In a careful review of over 400 individuals who tested positive for hepatitis C virus, 96% had conditions which would typically result in denial of treatment, even though they and society as a whole would benefit from such treatment.

Hepatitis C is a severe and chronic viral infection which is found throughout the globe, and more commonly among injection drug users (IDUs) - up to 40% to 95% in some studies. Treatment advances have resulted in steady improvement so that at present, approximately half of HCV-infected patients will recover with modern anti-viral treatment. Success is even greater among young people. Yet many infected individuals are denied treatment due to the application of restrictive criteria, including abstinence from illicit drug use or alcohol and absence of depression. The present study presents an analysis of 404 injection drug users in Baltimore, New York and Seattle aged 18-35 who tested positive for HCV. If such restrictions were applied, almost all would be denied treatment.

"There is no credible scientific basis to deny treatment for this group of HCV infected individuals," noted Dr. Holly Hagan, now a scientist at the National Development and Research Institutes, Inc. (NDRI) in New York City, who coordinated the Seattle site of the study. "Even injection drug users who are actively using drugs show low rates of reinfection and similar treatment completion rates to others," added Dr. Hagan, who is the study's lead author. Treatment of this group of young IDUs can have important public health implications by lowering the presence of the virus in the population. In addition, the requirement of regular visits with a medical facility can favor the entrance of persons into treatment for their drug use as well.

"It's time to be clear and consistent throughout the health care delivery system," said Dr. Steffanie Strathdee, senior author of the study who is now with the University of California, San Diego School of Medicine. "Antiviral treatment for HCV is an important public health intervention and the right choice for individuals infected with HCV, even those still injecting drugs."