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Injection drug use and the hepatitis C virus: Considerations for a targeted treatment approach-The case study of Canada

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Abstract

Infection with the hepatitis C virus (HCV) is a major public health burden in Canada and globally. The literature shows that injection drug use is currently the primary transmission route for HCV, and that a majority of injection drug users (IDUs) are currently infected with HCV in Canada. This article first reviews the burden of HCV within IDU populations and the transmission risks and the treatment implications speicifc to IDUs. Traditionally, IDUs have been excluded from HCV treatment unless abstaining from illicit drug use. However, recent research suggests that categorical exclusion is not medically necessary. A series of key questions about the feasibility of offering HCV treatment to IDUs in the specific Canadian context are considered, including concerns related to the motivation of treatment for IDUs, treatment delivery, treatment side effects, HCV reinfection, and the social environment. The article concludes that treatment of HCV-infected illicit drug users is both feasible and may be necessary to reduce transmission and adverse outcomes in this high-risk population.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Toronto, Ontario, Canada

    Benedikt Fischer &  Jürgen Rehm

  2. Public Health and Regulatory Policy Research Section, Centre for Addiction and Mental Health, 33 Russell Street, Room 2035, M5S 2S1, Toronto, Ontario, Canada

    Benedikt Fischer,  Emma Haydon &  Jürgen Rehm

  3. British Columbia Hepatitis Services, Vancouver, British Columbia, Canada

    Mel Krajden

  4. Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Mel Krajden

  5. Center for Interdisciplinary Addiction Research, Hamburg, Germany

    Jens Reimer

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  1. Benedikt Fischer
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  2. Emma Haydon
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  3. Jürgen Rehm
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  4. Mel Krajden
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Correspondence to Benedikt Fischer.

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Fischer, B., Haydon, E., Rehm, J. et al. Injection drug use and the hepatitis C virus: Considerations for a targeted treatment approach-The case study of Canada. J Urban Health 81, 428–447 (2004). https://doi.org/10.1093/jurban/jth128

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