Newly released EASL Hepatitis C Clinical Practice Guidelines speaks more about treatment among people who use drugs

Newly released EASL Hepatitis C Clinical Practice Guidelines are published in 2013 Journal of Hepatology. Comparing to the previous one release in 2011, it provides more information on hepatitis C treatment and drug addiction.

In the 2011 guidelines release the term “drug user” is found 3 times: the first one is a quick mention that “Genotype 3a is highly prevalent in European intravenous drug users within the section on epidemiology; the second one is found among HCV prevention recommendations, which says that “Drug users should be educated about modes of HCV transmission. They should be tested regularly for anti-HCV. Sterile needles should be provided” and the third one is a short paragraph on hepatitis C treatment among people who use drugs, who mainly says that “little data are available on the treatment of active drug users” and “no general recommendations for treatment active drug users can be made”.

The new guidelines release contains meanwhile quite a solid paragraph on active drug addicts and patients on stable maintenance substitution within the section about hepatitis C treatment of special groups. The paragraph provides more detailed epidemiological information, presents factors associated with HCV among people who inject drugs (PWID), explains how different substances, like, heroin, methadone, alcohol and tobacco impact liver state and treatment course, and gives more information about PWID as a group in general, which is relevant for treatment management. For the first time it provides also hepatitis C treatment among PWID supporting information saying that “in general, studies find that a history of IDU does not compromise adherence [84, 85], treatment completion [84, 201] or SVR” or “Modelling studies suggest that implementation of HCV treatment for PWID could reduce transmission [9,191].

Keeping in mind that active drug use is often the reason to refuse providing treatment, the new EASL guidelines sounds promising in increasing PWID access to hepatitis C treatment.

The new guidelines release you can find here