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Heroin Addiction and Related Clinical Problems: 2006, 08, 3 (pages: 37 - 48)

Treatment of chronic hepatitis C virus infection in intravenous drug addicts: State-of-the-Art

Guadagnino V., Trotta M. P., For the Nocchiero Study Group

Summary: Injection drug users (IDUs) are the largest group of people infected with the hepatitis C virus, and the group among whom most new infections occur. Treatingchronic hepatitis C in IDUs is important at an individual level and from a public health perspective. Treatment with a combination of pegylated interferon and ribavirin eradicates the virus in a high percentage of patients depending on the HCV genotype. Unfortunately, HCV-positive IDUs are rarely offered this treatment because of their assumed lower compliance with treatment, psychiatriccomorbidities, social discomfort and the risk of reinfection. However, there is increasing evidence that IDUs treated for HCV infection can achieve a sustained virological response comparable to that of non-IDUs. It has also been shown that drug addicts with HCV infection can benefit from anti-HCV treatment if it is given within the framework of a multidisciplinary standardized model of care. In this scenario, prospective clinical trials are warranted to establish new guidelines for the treatment of HCV infection in patients with drug dependence.