Hepatitis C antiviral treatment in special populations
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Early identification and consideration for antiviral treatment of chronic hepatitis C virus (HCV) is an important component in reducing morbidity and mortality. Although many HCV-infected patients do not meet current criteria for antiviral therapy, increased efforts are needed to overcome barriers to care and improve treatment candidacy. In select patients, clinicians should consider expanding treatment eligibility to reduce disease progression, lifethreatening complications, and future disease burden. Preliminary data suggest that HCV-infected "special populations," including those with substance abuse disorders (ie, injection drug use, alcohol abuse), those coinfected with HIV, and those with cirrhosis but only mild hepatic compromise, can be successfully treated with interferonbased preparations and ribavirin. Larger, controlled clinical studies are needed to validate preliminary results. Collaboration with a multidisciplinary team experienced in managing HCV infection is crucial to improve treatment candidacy, address the complexities involved with treating special populations, and optimize response and ensure safety in those undergoing HCV antiviral therapy.
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