Management of HCV and HIV infections among people who inject drugs

Grebely, Jasona; Tyndall, Mark W.b

Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e32834bcb36
HIV and hepatitis C coinfection: Edited by Jurgen Rockstroh and Gail Matthews
Abstract

Purpose of review: Despite a high burden of hepatitis C virus (HCV) and HIV infection among IDUs and the advent of effective therapies, assessment and treatment remain limited. The current review focuses on the management of HCV and HIV among IDUs, focusing particularly on recent strategies to enhance assessment, uptake and response to HCV and HIV treatment.

Recent findings: There are compelling data demonstrating that with the appropriate programs, treatment for HIV and HCV among IDUs is successful. However, assessment and treatment for HCV and HIV lags far behind the numbers of IDUs who could benefit from therapy, related to systems, provider and patient-related barriers to care. Strategies for enhancing assessment and treatment for HCV and HIV have been developed, including novel models integrating HCV/HIV care within existing community-based and drug and alcohol clinics, innovative methods for education delivery (including peer-support models) and directly observed therapy.

Summary: As we move forward, research must move beyond demonstrating that HCV and HIV infections can be successfully treated among IDUs. There is clear evidence that this is both feasible and effective. Novel strategies to enhance assessment, uptake and response to treatment should be evaluated among IDUs to elucidate mechanisms to enhance care for this underserved population.

Author Information

aThe Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, New South Wales, Australia

bThe Department of Medicine, Division of Infectious Diseases, The University of Ottawa, Ottawa, Ontario, Canada

Correspondence to Jason Grebely, The Kirby Institute for Infection and Immunity in Society, University of New South Wales, CFI Building, Corner of Boundary and West Streets, Sydney, NSW 2010, AustraliaTel: +61 2 93850900; fax: +61 2 93850876; e-mail: jgrebely@kirby.unsw.edu.au

© 2011 Lippincott Williams & Wilkins, Inc.