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Canadian Journal of Public Health

, Volume 97, Issue 6, pp 485–488 | Cite as

Hepatitis C, Illicit Drug Use and Public Health

Does Canada Really Have a Viable Plan?
  • Benedikt FischerEmail author
  • Kate Kalousek
  • Jürgen Rehm
  • Jeff Powis
  • Mel Krajden
  • Jens Reimer
Commentary
  • 1 Downloads

Abstract

Some 300,000 individuals are infected with the hepatitis C virus (HCV) in Canada. HCV infection is associated with major morbidity, mortality and health care costs; these indicators are projected to rise over the next decade. The vast majority of prevalent and incident HCV infections in Canada are illicit drug use-related; thus, the HCV disease burden can only be addressed through interventions targeting this primary risk factor. Both preventive (e.g., needle exchange, methadone treatment) and therapeutic (e.g., the accessibility of HCV treatment for illicit drug users) interventions aimed at HCV in illicit drug users have been broadly expanded in Canada in recent years. However, evidence suggests that existing preventive measures only offer limited effectiveness in reducing HCV risk exposure. Also, due to restricted resources, treatment for HCV currently only reaches an extremely small proportion (i.e., <5%) of HCV-infected drug users. Thus, on the basis of current HCV incidence as well as given interventions and their impact, Canada is not achieving a net reduction in the prevalence of HCV-related to illicit drug use. In order to reduce the HCV disease burden, Canada needs to reconsider the scope, delivery and resourcing of both preventive and treatment interventions targeting the primary risk population of illicit drug users.

MeSH terms

Hepatitis C public health street drugs; policy Canada 

Résumé

Au Canada, quelques 300 000 personnes sont infectées par le virus de l’hépatite C (VHC). L’infection à VHC entraîne des coûts énormes sur le plan de la morbidité, de la mortalité et des soins de santé; on prévoit que ces indicateurs augmenteront durant la prochaine décennie. La grande majorité des infections à VHC courantes et incidentes au Canada est reliée à la consommation de drogues illicites; le seul moyen d’alléger le fardeau de l’hépatite C est donc d’intervenir en ciblant ce facteur de risque primaire. On a élargi ces dernières années au Canada les mesures de prévention (l’échange d’aiguilles, le traitement à la méthadone) et de traitement (l’accès aux traitements anti-VHC) axées sur les consommateurs de drogues illicites infectés par le virus. Par contre, des données laissent croire que les moyens de prévention existants ont une efficacité limitée en ce qui a trait à la réduction du risque d’exposition au VHC. De plus, les ressources étant limitées, seule un très petite partie (moins de 5%) de la population des consommateurs de drogues illicites infectés a accès aux traitements anti-VHC. Donc, étant donné la fréquence actuelle d’infection par le VHC et le faible impact des mesures d’intervention, le Canada ne réussit pas à obtenir une réduction nette de la prévalence du VHC liée à la consommation de drogues illicites. Afin de réduire le fardeau de l’hépatite C, le Canada se doit de reconsidérer, de façon fondamentale, la portée, la distribution et les ressources attribuées aux interventions préventives et thérapeutiques visant la population la plus vulnérable, soit les consommateurs de drogues illicites.

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Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  • Benedikt Fischer
    • 1
    • 3
    Email author
  • Kate Kalousek
    • 1
    • 3
  • Jürgen Rehm
    • 1
    • 2
  • Jeff Powis
    • 1
    • 4
  • Mel Krajden
    • 5
    • 6
  • Jens Reimer
    • 7
  1. 1.Centre for Addiction and Mental HealthTorontoCanada
  2. 2.University of TorontoTorontoCanada
  3. 3.Centre for Addictions Research of British ColumbiaCanada
  4. 4.Toronto General HospitalTorontoCanada
  5. 5.B.C. Centre for Disease ControlVancouverCanada
  6. 6.University of British ColumbiaVancouverCanada
  7. 7.Centre for Interdisciplinary Addiction ResearchHamburgGermany

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